Brief Article
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World J Gastroenterol. Jan 28, 2013; 19(4): 561-568
Published online Jan 28, 2013. doi: 10.3748/wjg.v19.i4.561
Pilot study on efficacy of reduced cathartic bowel preparation with polyethylene glycol and bisacodyl
Zhi-Yuan Chen, He-Song Shen, Ming-Yue Luo, Chai-Jie Duan, Wen-Li Cai, Hong-Bing Lu, Guo-Peng Zhang, Yang Liu, Jerome Z Liang
Zhi-Yuan Chen, He-Song Shen, Ming-Yue Luo, Department of Radiology, the Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510655, Guangdong Province, China
Zhi-Yuan Chen, Department of Radiology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510006, Guangdong Province, China
Chai-Jie Duan, Research Center of Biomedical Engineering, Graduate School at Shenzhen, Tsinghua University, Shenzhen 518055, Guangdong Province, China
Wen-Li Cai, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States
Hong-Bing Lu, Guo-Peng Zhang, Yang Liu, Department of Biomedical Engineering, The Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
Jerome Z Liang, Departments of Radiology and Computer Science, State University of New York at Stony Brook, New York, NY 11794, United States
Author contributions: Chen ZY and Shen HS performed the experiments, analyzed the data and wrote the manuscript; Luo MY designed the study and provided financial support for this work; Duan CJ, Lu HB, Zhang GP and Liu Y were involved in the study conception and design; Cai WL and Liang JZ critically revised the manuscript; all the authors have read and approved the final version.
Supported by Grant from Guangdong Provincial Science and Technology Program, No. 2011B031800182
Correspondence to: Dr. Ming-Yue Luo, Department of Radiology, the Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510655, Guangdong Province, China. myluo720@163.com
Telephone: +86-20-38254100 Fax: +86-20-38254100
Received: October 30, 2012
Revised: December 15, 2012
Accepted: January 5, 2013
Published online: January 28, 2013
Abstract

AIM: To evaluate the efficacy of reduced cathartic bowel preparation with 2 L polyethylene glycol (PEG)-4000 electrolyte solution and 10 mg bisacodyl enteric-coated tablets for computed tomographic colonography (CTC).

METHODS: Sixty subjects who gave informed consent were randomly assigned to study group A, study group B or the control group. On the day prior to CTC, subjects in study group A were given 20 mL 40% wt/vol barium sulfate suspension before 3 mealtimes, 60 mL 60% diatrizoate meglumine diluted in 250 mL water after supper, and 10 mg bisacodyl enteric-coated tablets 1 h before oral administration of 2 L PEG-4000 electrolyte solution. Subjects in study group B were treated identically to those in study group A, with the exception of bisacodyl which was given 1 h after oral PEG-4000. Subjects in the control group were managed using the same strategy as the subjects in study group A, but without administration of bisacodyl. Residual stool and fluid scores, the attenuation value of residual fluid, and discomfort during bowel preparation in the three groups were analyzed statistically.

RESULTS: The mean scores for residual stool and fluid in study group A were lower than those in study group B, but the differences were not statistically significant. Subjects in study group A showed greater stool and fluid cleansing ability than the subjects in study group B. The mean scores for residual stool and fluid in study groups A and B were lower than those in the control group, and were significantly different. There was no significant difference in the mean attenuation value of residual fluid between study group A, study group B and the control group. The total discomfort index during bowel preparation was 46, 45 and 45 in the three groups, respectively, with no significant difference.

CONCLUSION: Administration of 10 mg bisacodyl enteric-coated tablets prior to or after oral administration of 2 L PEG-4000 electrolyte solution enhances stool and fluid cleansing ability, and has no impact on the attenuation value of residual fluid or the discomfort index. The former is an excellent alternative for CTC colorectum cleansing

Keywords: Colorectal cancer, Screening, Computed tomographic colonography, Polyethylene glycol, Bisacodyl