|LETTER TO THE EDITOR
|Year : 2019 | Volume
| Issue : 2 | Page : 64
Lecicarbon a suppositories: An acceptable bowel preparation for flexible sigmoidoscopy?
Caitlin M Brennan, Gordon A McFarlane, Louise M Robertson, Morag Douglas
Department of Surgery, Gilbert Bain Hospital, NHS Shetland, UK
|Date of Web Publication||27-Jun-2019|
Dr. Caitlin M Brennan
Department of Surgery, Gilbert Bain Hospital, Lerwick, NHS Shetland
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Brennan CM, McFarlane GA, Robertson LM, Douglas M. Lecicarbon a suppositories: An acceptable bowel preparation for flexible sigmoidoscopy?. World J Colorectal Surg 2019;8:64
|How to cite this URL:|
Brennan CM, McFarlane GA, Robertson LM, Douglas M. Lecicarbon a suppositories: An acceptable bowel preparation for flexible sigmoidoscopy?. World J Colorectal Surg [serial online] 2019 [cited 2019 Aug 18];8:64. Available from: http://www.wjcs.us.com/text.asp?2019/8/2/64/261546
Poor bowel preparation has been shown to be associated with lower quality indicators of colonoscopy performance, increased patient discomfort, and lower adenoma detection.
The incidence of adequate bowel preparation in frail elderly patients is often suboptimal. One factor may be that they do not have the dexterity to self-administer enemas in the outpatient setting. Suppositories are well tolerated, and previous trials with free fatty acid suppositories have shown comparable bowel cleansing to more traditional methods. Lecicarbon A suppositories function by a physical induction of reflex bowel evacuation caused by carbon dioxide release as the suppository contacts moisture; therapeutic indications include their use in emptying the colon before diagnostic procedures in the rectum.
We have trialed the use of Lecicarbon A suppositories in our department to investigate whether they were an acceptable bowel preparation to the patient offering good-quality bowel preparation and allowing adequate examination of the bowel compared to current practice.
Patients were assigned either Leicicarcbon A suppository or phosphate enema according to computer randomization. The outcome measures were (1) length scope reached, (2) adequate examination length reached for indication, (3) quality of bowel preparation, and (4) patient experience.
Twenty patients used Lecicarbon A suppository (LC) and 19 patients used phosphate enema (PE). Mean length of scope reached was equivocal (LC – 50 cm, PE– 50 cm). Adequate examination length reached for the procedure indication was less in the Lecicarbon group (LC – 45%, PE – 63%). Bowel preparation was deemed inadequate by the examiner (blinded to the type of preparation) more frequently in the Lecicarbon group (LC – 35%, PE – 21%). Side effects recorded by the patients were less frequent in the Enema group (LC – 9, PE – 5).
Bowel preparation with Lecicarbon A suppositories was less acceptable to patients. There appeared to be a higher rate of inadequate bowel preparation and a lower rate of adequate examination for the procedure with the Lecicarbon A suppositories. A standard phosphate enema gave better results in this study than Lecicarbon A suppositories for cleansing the bowel before flexible sigmoidoscopy.
Financial support and sponsorship
Conflicts of interest
Lecicarbon A suppositories were provided for free by a sales representative.
| References|| |
Romero RV, Mahadeva S. Factors influencing quality of bowel preparation for colonoscopy. World J Gastrointest Endosc 2013;5:39-46.
Zhang YY, Niu M, Wu ZY, Wang XY, Zhao YY, Gu J. The incidence of and risk factors for inadequate bowel preparation in elderly patients: A prospective observational study. Saudi J Gastroenterol 2018;24:87-92.
] [Full text]
Ormarsson OT, Asgrimsdottir GM, Loftsson T, Stefansson E, Kristinsson JO, Lund SH, et al.
Clinical trial: Free fatty acid suppositories compared with enema as bowel preparation for flexible sigmoidoscopy. Frontline Gastroenterol 2015;6:278-83.