CONTROLLED-STUDY OF CISAPRIDE-ASSISTED LAVAGE PREPARATORY TO COLONOSCOPY

Background: Traditional bower preparation before colonoscopy involves lavage with approximately 4 L of polyethylene-glycol (PEG)-electrolyte solution. Using prokinetic agents in addition to PEG-electrolyte lava ge may decrease the volume required and ease patient preparation. Meth ods: We conducted a blinded, placebo-controlled trial with the prokine tic agent, cisapride, in addition to standard PEG-electrolyte lavage. Patients were prospectively assigned to receive 20 mg of cisapride (n = 52) or placebo (n = 49) 30 minutes before drinking PEG-electrolyte s olution. The volume consumed, time to clean bower, side effects, and a cceptance were recorded. Adequacy of colon cleaning was scored by a ga stroenterologist blinded to group assignment. Results: Thirty-seven pe rcent of patients assigned to cisapride required more than 3500 mL of PEG-electrolyte, compared with 75% of patients receiving placebo (p < 0.001). Median time to clean bowel was 95 minutes for the cisapride gr oup and 120 minutes for those receiving placebo (p = 0.23). Side effec ts, patient acceptance, and quality of bowel preparation were not sign ificantly different. Conclusion: We conclude that administration of 20 mg of cisapride reduces the required volume of PEG-electrolyte soluti on for bower preparation.There were also favorable trends in the time required to achieve clean bowel, patient tolerance, and occurrence of side effects.