Randomized single blind trial of two low-volume bowel preparations for screening computed tomographic colonography

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Bowel preparation is crucial for computed tomographic colonography (CTC) quality.
• Screening CTC requires effective and well-tolerated bowel cleansing agents.
• Evaluating small-volume preparations is essential for patient compliance and diagnostic accuracy.

Purpose of the Study:

• To compare the quality of bowel preparation and patient acceptability of two small-volume regimens for screening CTC.
• To assess the safety and efficacy of magnesium/bisacodyl/picolax versus polyethylene glycol (PEG)/picolax.
• To determine the optimal bowel preparation for average-risk colorectal cancer screening via CTC.

Main Methods:

• A randomized trial involving asymptomatic, average-risk subjects undergoing screening CTC.
• Participants received either magnesium/bisacodyl/picolax or PEG/picolax bowel preparation.
• Blinded assessment of CTC images for residual feces/fluid and patient questionnaire on acceptability.

Main Results:

• The magnesium/bisacodyl/picolax preparation was discontinued in 5% of subjects due to syncope or presyncope.
• Polyethylene glycol (PEG)/picolax was administered to 137 subjects without significant adverse events.
• Both preparations yielded similar quality of bowel cleansing for CTC reporting, with minimal residue.

Conclusions:

• Small-volume bowel preparations are generally well-tolerated for screening CTC, achieving minimal residue.
• The magnesium/bisacodyl/picolax preparation demonstrated an unacceptable incidence of syncope and is no longer recommended.
• Polyethylene glycol (PEG)/picolax represents a safe and effective option for bowel preparation in CTC screening.