Same-day colonoscopy preparation with Senna alkaloids and bisacodyl tablets: a pilot study.
OBJECTIVE
To evaluate the efficacy of same-day bowel preparation with Senna alkaloids combined with bisacodyl tablets in routine colonoscopy procedures.


METHODS
Between March and June 2013, a same-day bowel preparation was implemented in our endoscopy unit. The preparation consisted of a semi-liquid, fiber-free diet one day prior to the procedure, with two bisacodyl tablets after lunch and dinner, and 250 mL of Senna alkaloid with 1.5 L of drinking water at 6 am the day of the procedure. The quality control parameters of colonoscopy were evaluated and implemented according to the guidelines of the American Society for Gastrointestinal Endoscopy. The pre-procedure, during-procedure and post-procedure patient data were collected and analyzed: (1) pre-procedure (age, gender, comorbid diseases, colonoscopy indications, complete lack of compliance with the bowel preparation protocol); (2) during-procedure (sedation dose, duration of colonoscopy, withdrawal time, cecal intubation rate, polyp detection rate, Boston Bowel Preparation Scores and presence of foam and clear liquid); and (3) post-procedure (visual analogue scale score, pain during the procedure, patient satisfaction and premature withdrawal due to the insufficient bowel preparation).


RESULTS
A total of 75 patients were included in this study with a mean age of 54.64 ± 13.29 years; 53.3% (40/75) were female and 46.7% (35/75) were male. A complete lack of compliance with the bowel preparation protocol was seen in 6.7% of patients (5/75). The mean total duration of colonoscopy was 16.12 ± 6.51 min, and the mean withdrawal time was 8.89 ± 4.07 min. The cecal intubation rate was 93.8% (61/64) and the polyp detection rate was 40% (30/75). The mean Boston Bowel Preparation Score was 7.38 ± 1.81, with the following distribution: right colon, 2.34 ± 0.89; transverse colon, 2.52 ± 0.67; left colon, 2.52 ± 0.63. The mean visual analogue scale score was 4.59 ± 1.57. Due to insufficient bowel preparation, seven patients (7/75; 9.3%) were asked to repeat the procedure. Of these, five patients had poor or modest compliance with the protocol, and two patients reported constipation. Premature withdrawal due to insufficient bowel preparation was 2.7% (2/75). The overall satisfaction with the protocol was 86.7% (65/75), with patients reporting they would prefer the same protocol in a repeat procedure.


CONCLUSIONS
The same-day administration of Senna alkaloids appears to be a safe and effective bowel cleansing protocol for colonoscopy procedures.
Erdinc Yenidogan, Ismail Okan, Huseyin Ayhan Kayaoglu, Gokhan Giray Akgul, Mufit Sansal, Servet Tali, Zeki Ozsoy, Mustafa Sahin, Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, 60100 Tokat, Turkey.
Erdinc
E
Yenidogan
Erdinc Yenidogan, Ismail Okan, Huseyin Ayhan Kayaoglu, Gokhan Giray Akgul, Mufit Sansal, Servet Tali, Zeki Ozsoy, Mustafa Sahin, Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, 60100 Tokat, Turkey.
Ismail
I
Okan
Erdinc Yenidogan, Ismail Okan, Huseyin Ayhan Kayaoglu, Gokhan Giray Akgul, Mufit Sansal, Servet Tali, Zeki Ozsoy, Mustafa Sahin, Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, 60100 Tokat, Turkey.
Huseyin Ayhan
HA
Kayaoglu
Erdinc Yenidogan, Ismail Okan, Huseyin Ayhan Kayaoglu, Gokhan Giray Akgul, Mufit Sansal, Servet Tali, Zeki Ozsoy, Mustafa Sahin, Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, 60100 Tokat, Turkey.
Gokhan Giray
GG
Akgul
Erdinc Yenidogan, Ismail Okan, Huseyin Ayhan Kayaoglu, Gokhan Giray Akgul, Mufit Sansal, Servet Tali, Zeki Ozsoy, Mustafa Sahin, Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, 60100 Tokat, Turkey.
Mufit
M
Sansal
Erdinc Yenidogan, Ismail Okan, Huseyin Ayhan Kayaoglu, Gokhan Giray Akgul, Mufit Sansal, Servet Tali, Zeki Ozsoy, Mustafa Sahin, Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, 60100 Tokat, Turkey.
Servet
S
Tali
Erdinc Yenidogan, Ismail Okan, Huseyin Ayhan Kayaoglu, Gokhan Giray Akgul, Mufit Sansal, Servet Tali, Zeki Ozsoy, Mustafa Sahin, Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, 60100 Tokat, Turkey.
Zeki
Z
Ozsoy
Erdinc Yenidogan, Ismail Okan, Huseyin Ayhan Kayaoglu, Gokhan Giray Akgul, Mufit Sansal, Servet Tali, Zeki Ozsoy, Mustafa Sahin, Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, 60100 Tokat, Turkey.
Mustafa
M
Sahin
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000470:Alkaloids / Q000008:administration & dosage*; D001726:Bisacodyl / Q000008:administration & dosage*; D002400:Cathartics / Q000008:administration & dosage*; D003113:Colonoscopy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012676:Senna Extract / Q000008:administration & dosage*; D013607:Tablets; D013997:Time Factors; D014421:Turkey
D000470:Alkaloids; D002400:Cathartics; D006993:Hypnotics and Sedatives; D013607:Tablets; D001726:Bisacodyl; D012676:Senna Extract
Bisacodyl; Bowel preparation; Colonoscopy; Same-day preparation; Senna alkaloid