A randomised trial of hospital versus home administered enemas for flexible sigmoidoscopy

A prospective randomized single blind trial of Fleet phosphate enema versus glycerin suppositories as preparation for flexible sigmoidoscopy

“…Although common side effects with rectal preparations include abdominal cramps and fecal leakage, the most commonly encountered adverse effect of enema is abdominal cramps [14,15]. Approximately, a quarter of patients in our study receiving single Fleet enema experienced moderate to severe abdominal cramps.…”

“…Although home-administered enemas have been found to be acceptable by patients in some studies [6,9]; this finding is not universal [14]. In a study conducted by Lund et al [14] in Nottingham, almost half of the patients declined to take an enema at home preferring administration in hospital. The reasons given for the refusal to use home-administered enemas were too difficult to use (34%), fear of mess (14%) and failure to understand the instructions (4%).…”

“…The endoscopist questionnaire reflected the efficacy of the preparation and included instruments such as 'quality of bowel preparation [6]' and 'depth of insertion [13]'. The patient questionnaire was designed to evaluate patient acceptability using instruments which include 'ease of use of preparation [13]' and 'experience of bowel cramps [14,15]'.…”

Non-laxative CT colonography with barium-based faecal tagging: is additional phosphate enema beneficial and well tolerated?

“…We hypothesised that one potentially simple and safe way to improve left-sided colonic preparation in non-laxative CTC was to administer a phosphate enema just prior to the examination. It is known from the endoscopic literature, for example, that phosphate enema is effective and well tolerated prior to flexible sigmoidoscopy [16,17].…”

“…The majority of colorectal cancers arise in the rectum and distal colon, with approximately 50% arising from the rectum and rectosigmoid area, with a further 25% arising from the sigmoid colon [15]. It is known that self-administered phosphate enema prior to flexible sigmoidoscopy is effective, well tolerated and more acceptable than full bowel cleansing regimes such as sodium picosulphate [16,17].…”