Multidisciplinary Approach Versus Conventional Approach in Colonic Preparation of Hospitalized Patients
Status:
Unknown status
Trial end date:
2013-12-01
Target enrollment:
Participant gender:
Summary
Colonoscopy is the gold standard diagnostic procedure for colonic disease. Excellent bowel
cleansing is critical for this procedure. However, an inadequate bowel cleansing is a common
problem that occurs up to 20% of procedures. This fact has a deep clinical and economical
impact. In fact, inadequate bowel preparation is associated to misdiagnosis in 30% of
lesions. Moreover several clinical conditions such as cirrhosis, antidepressant drugs, and
hospitalized patients are predictive factors of inadequate colonic preparations. These
circumstances have promoted multiple clinical trials, however there is no consensus about the
optimal strategy for colonic cleansing. Education in colonic preparation has obtained
conflicting results. Polyethylene glycol (PEG) and sodium phosphate solutions have been the
commonest preparations used with a similar efficacy. However, the large volume to ingest (4
litters) makes PEG compliance difficult. Likewise, sodium phosphate also contains high levels
in sodium and phosphate which contraindicate its use in elderly patients and / or with
comorbidity. The use of adjuvants such as olive oil and bisacodyl allows reducing the volume
of polyethylene glycol thereby improving the tolerance and right colon preparation.
The aim of this study is to compare the efficacy of a multidisciplinary approach (education,
fiber free diet, polyethylene glycol (PEG) 2L, and adjuvant bisacodyl + olive oil) vs. a
conventional approach (fiber free diet+ PEG 4L in split doses ) in cleaning the colon of
hospitalized patients.