title: Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability.
abstract: OBJECTIVE
  To compare a 2 day bowel preparation regime of barium, iodine and a mild stimulant laxative with a 1 day iodine-only regime for CT colonography (CTC).
  
  
  METHODS
  100 consecutive patients underwent CTC. The first 50 patients (Regime 1) ingested 1 bisacodyl tablet twice a day 3 days before CTC and 1 dose each of 50 ml of barium and 20 ml of iodinated contrast per day starting 2 days before CTC. The second 50 patients (Regime 2) ingested 3 doses of iodinated contrast over 24 h prior to CTC. Volumes of residual stool and fluid, and the effectiveness of stool and fluid tagging, were graded according to methods established by Taylor et al (Taylor S, Slaker A, Burling D, Tam E, Greenhalgh R, Gartner L, et al. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging. Eur Radiol 2008; 18: 32-42). A 3 day low-residue diet was taken by both cohorts. Questionnaires rating the side-effects and burden of the bowel preparation were compared to a control cohort of patients undergoing barium enema.
  
  
  RESULTS
  The proportion of colons producing none/scattered stool (score 1) was 90.3% with Regime 1 and 65.0% with Regime 2 (p<0.005). Any residual stool was significantly better tagged with Regime 1 (score 5), with 91.7% of Regime 1 exhibiting optimum tagging vs 71.3% of Regime 2 (p<0.05). No significant differences in side-effects between the bowel preparation regimes for CTC were elicited. Bowel preparation for barium enema was tolerated significantly worse than both of the CTC bowel preparation regimes.
  
  
  CONCLUSIONS
  Regime 1, containing a 3 day preparation of a mild laxative, barium and iodine, produced a significantly better prepared colon, with no difference in patient acceptability.
authors.affiliation: Department of Radiology, Southmead Hospital, Westbury-on-Trym, Bristol, UK. adrianpollentine@doctors.org.uk
authors.forename: A
authors.initials: A
authors.lastname: Pollentine
authors.forename: A
authors.initials: A
authors.lastname: Mortimer
authors.forename: P
authors.initials: P
authors.lastname: McCoubrie
authors.forename: L
authors.initials: L
authors.lastname: Archer
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D018798:Anemia, Iron-Deficiency / Q000209:etiology; D001466:Barium Sulfate / Q000008:administration & dosage; D001726:Bisacodyl / Q000008:administration & dosage; D001826:Body Fluids; D002400:Cathartics / Q000008:administration & dosage*; D023881:Colonography, Computed Tomographic / Q000379:methods* / Q000592:standards; D015179:Colorectal Neoplasms / Q000175:diagnosis; D003287:Contrast Media / Q000008:administration & dosage*; D003974:Diatrizoate Meglumine / Q000008:administration & dosage; D004338:Drug Combinations; D004733:Enema / Q000379:methods; D005243:Feces; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007455:Iodine / Q000008:administration & dosage; D054368:Laxatives / Q000008:administration & dosage*; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D002400:Cathartics; D003287:Contrast Media; D004338:Drug Combinations; D054368:Laxatives; D001726:Bisacodyl; D001466:Barium Sulfate; D003974:Diatrizoate Meglumine; D007455:Iodine