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Year : 2019  |  Volume : 8  |  Issue : 2  |  Page : 64

Lecicarbon a suppositories: An acceptable bowel preparation for flexible sigmoidoscopy?

Department of Surgery, Gilbert Bain Hospital, NHS Shetland, UK

Date of Web Publication27-Jun-2019

Correspondence Address:
Dr. Caitlin M Brennan
Department of Surgery, Gilbert Bain Hospital, Lerwick, NHS Shetland
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/WJCS.WJCS_4_19

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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 2020 Apr 9];8:64. Available from: http://www.wjcs.us.com/text.asp?2019/8/2/64/261546

Dear Editor,

Poor bowel preparation has been shown to be associated with lower quality indicators of colonoscopy performance, increased patient discomfort, and lower adenoma detection.[1]

The incidence of adequate bowel preparation in frail elderly patients is often suboptimal.[2] 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.[3] 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.[4]

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 19patients used phosphate enema(PE). Mean length of scope reached was equivocal(LC–50cm, PE–50cm). 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. Astandard 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 Top

RomeroRV, MahadevaS. Factors influencing quality of bowel preparation for colonoscopy. World J Gastrointest Endosc 2013;5:39-46.  Back to cited text no. 1
ZhangYY, NiuM, WuZY, WangXY, ZhaoYY, GuJ. The incidence of and risk factors for inadequate bowel preparation in elderly patients: Aprospective observational study. Saudi J Gastroenterol 2018;24:87-92.  Back to cited text no. 2
[PUBMED]  [Full text]  
OrmarssonOT, AsgrimsdottirGM, LoftssonT, StefanssonE, KristinssonJO, LundSH, etal. Clinical trial: Free fatty acid suppositories compared with enema as bowel preparation for flexible sigmoidoscopy. Frontline Gastroenterol 2015;6:278-83.  Back to cited text no. 3
Lecicarbon A & C Suppositories, Summary of Product Characteristics. eMedicines Complete: 09January, 2018. Available from: https://www.medicines.org.uk/emc/product/1913/smpc.[Last retrieved on 2019Jan23].  Back to cited text no. 4


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