Randomized clinical trial of two colonoscopy preparation methods for elderly patients

Colonic lavage with enemas or with Golytely are standard preparation methods for colonoscopy. Previous studies have demonstrated that Golytely has a statistically significant advantage in both adequacy of preparation and patient tolerance. To determine if these effects are present in the elderly, we performed a randomized clinical trial on 124 consecutive patients scheduled for colonoscopy who were greater than or equal to 75 years of age. Sixty-three patients were randomized to receive Golytely; 17 were inpatients, 33 were outpatients, and colonoscopy was canceled in 13. Sixty-one patients were randomized to receive the enema preparation; 17 were inpatients, 30 were outpatients, and colonoscopy was canceled in 14. For adequacy of the preparation, no differences were statistically significant, but the enema preparation was superior in outpatients while Golytely was superior in inpatients. Patients tolerated the enema preparation better, a finding present in both outpatients and inpatients. Contrary to previous reports of a significant advantage with Golytely, patients greater than or equal to 75 years old did not enjoy this advantage, but seemed to tolerate enemas better than Golytely with little difference in adequacy of the preparation.