Bowel cleansing before CT colonography: comparison between two minimal-preparation regimens

• Published in: European radiology 2015-01, Vol.25 (1), p.203-210
• Main Authors: Iafrate, F., Iannitti, M., Ciolina, M., Baldassari, P., Pichi, A., Laghi, A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Bisacodyl - pharmacology; Cathartics - pharmacology; Colon; Colonic Diseases - diagnostic imaging; Colonography, Computed Tomographic - methods; Contrast agents; Diagnostic Radiology; Diet; Female; Gastrointestinal; Humans; Imaging; Internal Medicine; Interventional Radiology; Iodine; Laxatives; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Patients; Polyethylene glycol; Polyethylene Glycols - pharmacology; Prospective Studies; Radiology; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-014-3345-0

Aim To compare two regimens of reduced bowel preparation and faecal tagging for CT colonography. Materials and methods Single centre, prospective, randomized, noninferiority study, in which 52 consecutive adults underwent routine CT colonography. Patients, following a three-day low-fibre diet, received one of the two reduced preparations: 1-L polyethylene glycol and four tablets of bisacodyl in association with 90 mL of Iopamidol for faecal tagging administered on the same day as CTC examination (group 1); or a standard "iodine-only" preparation, consisting in 180 ml of Iopamidol the day before the examination (group 2). Primary outcome was the overall quality of bowel preparation. Results Twenty-six patients per group were included. Per segment analysis showed preparation of diagnostic quality in 97.4 % of segments in group 1 and in 95.5 % in group 2 ( p  = ns). Per-patient analysis showed optimal quality of preparation in 76.9 % of patients in group 1 and in 84.6 % in group 2 ( p  = ns). Patient tolerability to both preparations was not different. Conclusion A limited bowel preparation consisting of 1-L PEG and four tablets of bisacodyl in association with 90 mL of Iodine for faecal tagging administered on the same day as CTC examination is feasible and offers bowel cleansing comparable to "iodine-only" preparation. Key Points • Low-dose PEG bisacodyl and Iopamidol preparation is feasible, providing adequate bowel cleansing. • Faecal tagging is not different from the two limited preparations. • Patient tolerability to the two colon cleansing regimens is similar.