title: The comparison of saline enema and bisacodyl in rectal preparation before anorectal surgery.
abstract: BACKGROUND
  Given the limited data on the need of mechanical bowel preparation application before anorectal surgeries and the preferred method for bowel preparation, we aimed to compare saline enema and bisacodyl in rectal preparation before anorectal surgery.
  
  
  METHODS
  This is a randomized clinical trial study. Seventy-nine hospitalized patients for anorectal surgery (hemorrhoid, fissure, and fistula) were recruited by convenient sampling and then randomly allocated to receive 500 cc Saline by rectal enema or six bisacodyl tablets (Sobhan company) beginning from a day before the operation in order to prepare the bowel. After surgery, surgeons' satisfaction of the surgery and patients' satisfaction of the preparation process were evaluated in the ward using Likert score by a nurse blind to the study. Also, the patients were interviewed for pain after the first defecation, using numeric rating scale based on a 0-10 scores. All patients were actively followed-up after discharge for 1 mo concerning postoperative complications. The obtained data were analyzed by SPSS software (version 16), Mann-Whitney, chi-squared, and Fisher exact tests at the significant level of P < 0/0.5.
  
  
  RESULTS
  A total of 79 patients participated in the study, 38 received 500-cc saline by rectal enema and 41 bisacodyl tablets. No significant differences were observed between the two groups in most variables except for pain after the first defecation (P = 0.032).
  
  
  CONCLUSIONS
  According to the results, the bisacodyl approach results in less pain in the first postoperative defecation and fewer complications than the rectal enema. Thus, bisacodyl can be suggested as a superior counterpart for enema.
authors.affiliation: Department of Cardiovascular Surgery, Surgery and Trauma Research Center, Birjand University of Medical Sciences, Birjand, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Amouzeshi
authors.affiliation: Surgery and Trauma Research Center, Faculty of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran. Electronic address: amoozeshiz9039@bums.ac.ir.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Amouzeshi
authors.affiliation: Department of General Surgery, Surgery and Trauma Research Center, Birjand University of Medicine Sciences, Birjand, Iran.
authors.forename: Ghodratollah
authors.initials: G
authors.lastname: Naseh
authors.affiliation: Department of General Surgery, Surgery and Trauma Research Center, Birjand University of Medicine Sciences, Birjand, Iran.
authors.forename: Seyyed Amir
authors.initials: SA
authors.lastname: Vejdan
authors.affiliation: Department of Anesthesiology, Surgery and Trauma Research Center, Imam Reza Hospital, Birjand University of Medical Sciences, Birjand, Iran.
authors.forename: Amir Saber
authors.initials: AS
authors.lastname: Tanha
authors.affiliation: Department of Cardiovascular Surgery, Surgery and Trauma Research Center, Birjand University of Medical Sciences, Birjand, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Hosseinzadeh
authors.affiliation: Department of General Surgery, Surgery and Trauma Research Center, Birjand University of Medicine Sciences, Birjand, Iran.
authors.forename: Seyyedeh Raziyeh
authors.initials: SR
authors.lastname: Vagharseyyedin
mesh_terms: D000328:Adult; D001726:Bisacodyl; D002400:Cathartics; D004733:Enema / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011300:Preoperative Care / Q000706:statistics & numerical data*; D012007:Rectum / Q000601:surgery*; D012965:Sodium Chloride / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D002400:Cathartics; D001726:Bisacodyl; D012965:Sodium Chloride
keywords: Anorectal surgery; Bisacodyl; Rectal preparation; Saline enema