PREPARATION OF THE COLON FOR DOUBLE-CONTRAST BARIUM ENEMA - COMPARISON OF PICOLAX, PICOLAX WITH CLEANSING ENEMA AND CITRAMAG (2 SACHETS) - A RANDOMIZED PROSPECTIVE TRIAL

A randomized prospective trial was undertaken on 196 consecutive patie nts referred for double-contrast barium enema examination to assess th e relative efficacy of three colon cleansing regimes: Citramag (2 sach ets), Picolax and Picolax with a preliminary cleansing enema. Each of the regimes was preceded by a 5 day low residue diet. The radiographs from the examinations were assessed on a double-blind basis. The quali ty of bowel preparation was significantly poorer (P < 0.001) in the gr oup receiving the preliminary cleansing enema, notably with respect to mucosal coating, compared with the other two groups. The quality of t he preparation was slightly better in the group receiving Picolax alon e than in the Citramag group (P < 0.01), the difference being most app arent in the proximal colon. The laxatives were equally well tolerated . The study has formed the basis of a departmental audit. As a result, the bowel preparation has been standardized to a 5 day period of diet ary restriction followed by 2 Picolax sachets. This measure has improv ed efficiency within the department with no sacrifice in quality.