Castor Oil and Bisacodyl Versus Sodium Picosulphate Magnesium Citrate for Bowel Cleansing Prior to Colonoscopy in a...

The cost and availability are among factors that determine bowel preparation regimen for colonoscopy.

To assess the efficacy of an alternative bowel preparation regimen of Castor oil/Bisacodyl (CaO/B) for colonoscopy in a limited resource setting.

A retrospective cohort study of patients undergoing colonoscopy in an endoscopy referral centre in Port Harcourt Rivers State Nigeria from June 2014 to September 2019. Patients who had bowel preparation prior to colonoscopy with CaO/B were grouped and compared with a control group of patients that received sodium picosulphate magnesium citrate (SPMC). The variables collated were sociodemographics, primary indication, comorbidities, quality of bowel preparation (Aronchick scale), polyp detection and caecal intubation. Statistical analysis was performed using IBM SPSS version 21.

A total of 258 patients undergoing colonoscopy met the inclusion criteria with 118 prepared with CaO/B and 140 patients with SPMC. The mean age of patients in the groups were 53.9 ± 11.2 years and 54.7 ± 12.8 years respectively; a total of 192 males and 66 females with a near even distribution in both groups. Bowel preparation was Excellent/Good in 51 patients using CaO/B and 108 for SPMC (p = <0.0001). No statistical difference was noted in the caecal intubation and polyp detection rates between the 2 groups- p values 0.395 and 0.990 respectively.

Castor oil/ Bisacodyl regimen is cheap but not consistently associated with adequate bowel preparation for colonoscopy. Expertise of endoscopists and copious lavage are crucial when CaO/B regimen is used for bowel cleansing.