title: Home rectal evacuation prior to a colorectal clinic appointment: a prospective, randomized, controlled, single-blind trial.
abstract: OBJECTIVE
  The presence of faeces in the rectum can limit the effectiveness of diagnostic rigid sigmoidoscopy and therapeutic proctoscopy. This study was undertaken to determine whether home self-administration of a Microlette Micro-enema® or two glycerine suppositories improves the view on rigid sigmoidoscopy and to assess patient acceptability.
  
  
  METHODS
  Patients referred with colorectal symptoms were prospectively randomized into three groups of 50. Patients in Groups I and II were sent a Microlette Micro-enema® or two glycerine suppositories, respectively, along with instructions for home self-administration. Group III comprised unmedicated controls.
  
  
  RESULTS
  Compliance was 98%. There was no significant difference in faecal loading between Groups I and II, but both groups had significantly more patients with empty rectums in comparison with Group III (P < 0.001). The median (interquartile range) distances in cm from the anal verge reached on rigid sigmoidoscopy in Groups I, II and III were 15.0 (15.0-20.0), 18.0 (15.0-20.0) and 15.0 (4.25-15.0), respectively (Groups I vs III and Groups II vs III P < 0.001; Groups I vs II P = 0.03). Quality of views on rigid sigmoidoscopy were best in Group II (Groups I vs III and Groups II vs III P < 0.001; Groups I vs II P = 0.04). Four patients in Group I and two in Group II found home self-administration of the enema/suppositories inconvenient or unacceptable.
  
  
  CONCLUSIONS
  Home self-administration of two glycerine suppositories prior to a colorectal clinic visit is simple, inexpensive and acceptable to patients and allows better views on rigid sigmoidoscopy.
authors.affiliation: Department of Surgery, Derbyshire Royal Infirmary, Derby, UK.
authors.lastname: Lobo
authors.lastname: Riddick
authors.lastname: Iftikhar
authors.lastname: Gudgeon