title: Bowel preparation regimen for computed tomography colonography.
abstract: OBJECTIVE
  This study was designed to determine whether a reduction in oral contrast dose and a change in timing of administration will result in less residual material in the colonic lumen.
  
  
  METHODS
  We retrospectively assessed, in a blinded fashion, the amount and nature of residual material in the colon in 40 patients who received computed tomography colonography. Half of the cohort received the standard bowel-preparation regimen, whereas a sex- and age-matched test arm received the modified regimen. A scoring system that consisted of metrics to quantify the nature and extent of residual fluid and solid material was defined. Image analysis was conducted with the investigators blinded to the group assignment of each patient. Three different trained observers independently reviewed and scored the 6 colonic segments in supine and prone positions for each patient in the cohort. In cases in which interobserver discrepancies existed, the observers reanalyzed the images together to come to an agreement on scores.
  
  
  RESULTS
  The new bowel-preparation regimen resulted in significantly less "sticky coat" (P < .005), a problematic phenomenon in which the colonic mucosa is covered in a thin coating of residual contrast and fecal material. There was no difference in the amount of residual fluid. Fewer masses of stool were noted with the new preparation, but this was not found to be statistically significant.
  
  
  CONCLUSIONS
  A new bowel-preparation regimen that consisted of lower quantities of contrast administered earlier in the day preceding computed tomography colonography resulted in a lower incidence of adherent contrast and fecal matter. The reduction of this "sticky coat" problem not only improved radiologic analysis of the colon but may permit same-day therapy via colonoscopy if indicated on imaging.
authors.affiliation: Department of Radiology, Victoria Hospitals, Victoria, British Columbia, Canada.
authors.forename: Carola
authors.initials: C
authors.lastname: Behrens
authors.forename: Richard
authors.initials: R
authors.lastname: Eddy
authors.forename: Giles
authors.initials: G
authors.lastname: Stevenson
authors.forename: Louise
authors.initials: L
authors.lastname: Audet
authors.forename: John
authors.initials: J
authors.lastname: Mathieson
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D002400:Cathartics / Q000008:administration & dosage*; D002951:Citrates; D023881:Colonography, Computed Tomographic / Q000379:methods*; D003113:Colonoscopy; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D010847:Picolines / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D002400:Cathartics; D002951:Citrates; D003287:Contrast Media; D009942:Organometallic Compounds; D010847:Picolines; D001466:Barium Sulfate; C005701:picosulfate sodium