Comparison of laxatives used in CT colonography with full bowel preparation

Purpose. Our study aimed to identify an optimal full-cleanse bowel preparation scheme for patients undergoing CT colonography.

Material and methods. The final sample included 118 patients: 81 females (68.6%), with the median age being 75 years (IQR 675-80 years). For bowel preparation 39 (33.1%) patients used PM/Ca, 36 (30.5%) – 2 L PEG + Asc, 19 (16.1%) – 3 L PEG, 24 (20.3%) – 4 L PEG. Otherwise, the preparation did not differ in all four groups. Visual assessment of residual stool, residual fluid, and distension degree was performed using a 4-point Likert scale. The patient’s subjective tolerance assessment was executed according to the survey results using a 5-point Likert scale.

Results. There were no statistically significant differences in quality of bowel preparation in all four groups. Mean value of the total residual stool score in groups was 46.2 ± 2.87 for PM/Ca; 46.9 ± 2.34 for 2 L PEG + Asc; 46.5 ± 1.98 for 3 L PEG; 45.9 ± 3.18 for 4 L PEG (p > 0.05). The median of the total residual fluid score in groups was 36 (33–38) for PM/Ca; 36.5 (34–39) for 2 L PEG + Asc; 37 (36–39) for 3 L PEG; 36 (34–40) for 4 L PEG (p > 0.05). Mean value of the total distention degree score in groups was 43 ± 4.34 for PM/Ca; 44.6 ± 3.13 for 2 L PEG + Asc; 44.2 ± 3.98 for 3 L PEG; 43.5 ± 4.9 for 4 L PEG (p > 0.05). There was a statistically significant difference in the patient tolerance total score, depending on the laxative (p = 0.001). The total preparation score was significantly lower for PM/Ca when compared with 2 L PEG + Asc. (p = 0.021), 3 L PEG (p = 0.001), and 4 L PEG (p = 0.043).

Conclusion. Use of PM/Ca in CTC preparation lowers the burden of full cleanse exam preparation and can be recommended as a safe laxative choice, including senior age patients. 

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