An interview study analysing patients' experiences and perceptions of non-laxative or full-laxative preparation with faecal tagging prior to CT colonography

Abstract

An interview study analysing patients' experiences and perceptions of non-laxative or full-laxative preparation with faecal tagging prior to CT colonography. Clin Radiol , 68 (5) pp. 472-478. 10.1016/j.crad.2012.10.012. ArticleAn interview study analysing patients' experiences and perceptions of non-laxative or full-laxative preparation with faecal tagging prior to CT colonography Classifications: Gastrointestinal; CT AbstractAim: This study compared patients' experiences of either non-or full-laxative bowel preparation with additional faecal tagging and subsequent CT colonography using in-depth interviews to elicit detailed responses.Materials and Methods: Patients who received CT colonography after non-(N = 9) or full-laxative (N = 9) preparation participated in a semi-structured telephone interview at least two days after investigation. Full-laxative preparation consisted of magnesium citrate and sodium picosulphate administered at home (or polyethylene glycol, if contraindicated), followed by hospital-based faecal tagging with iohexol. Non-laxative preparation was home-based barium sulphate for faecal tagging.Interviews were transcribed and thematically analysed to identify recurrent themes on patients' perceptions and experiences.Results: Experiences of full-laxative preparation were usually negative and characterised by pretest diarrhoea that caused significant interference with daily routine. Post-test flatus was common. Non-laxative preparation was well-tolerated; patients reported no or minimal changes to bowel habit and rapid return to daily routine. Patients reported worry and uncertainty about the purpose of hospital-based faecal tagging. This also added burden from waiting before testing.Conclusion: Patients' responses supported previous findings that non-laxative preparation is more acceptable than full-laxative preparation but both can be improved. Faecal tagging used in combination with laxative preparation is poorly understood, adding burden and worry. Home-based non-laxative preparation is also poorly understood and patients require better information on the purpose and mechanism in order to give fully informed consent. This may also optimise adherence to instructions. Allowing home-based self-administration of all types of preparation would prevent waiting before testing.

Assessment of 3 Bowel Preparation Protocols for Computed Tomography Pneumocolonography in Normal Dogs

“…International consensus guidelines for people recommend that CT pneumocolonography is performed after full cathartic bowel cleansing and many patients perceive bowel cleansing as the worst aspect of the test . In an effort to avoid cathartic bowel cleansing, alternative methods such as a low‐residue diet, or a partial colonic cleansing in conjunction with fecal tagging have been used .…”

“…A variety of orally administered agents including barium and iodinated‐based contrast media are used for fecal tagging in people . Hospital‐based protocols using fecal tagging with orally administered contrast medium are acceptable to people in terms of discomfort and side effects but there was dissatisfaction with the necessary postponement of imaging when this is initiated in hospital before CT pneumocolonography and home‐based protocols were more positively perceived …”

“…[3][4][5][6][7][8] International consensus guidelines for people recommend that CT pneumocolonography is performed after full cathartic bowel cleansing and many patients perceive bowel cleansing as the worst aspect of the test. 9 In an effort to avoid cathartic bowel cleansing, alternative methods such as a lowresidue diet, 10,11 or a partial colonic cleansing in conjunction with fecal tagging have been used. 12 Labeling stool in the noncathartic prepared colon with an oral contrast agent is possible, and feasibility studies have shown that colorectal neoplasms can be discriminated from contrast-labeled stool.…”

“…11,12,17 Hospital-based protocols using fecal tagging with orally administered contrast medium are acceptable to people in terms of discomfort and side effects but there was dissatisfaction with the necessary postponement of imaging when this is initiated in hospital before CT pneumocolonography and home-based protocols were more positively perceived. 9 Bowel cleansing is usually recommended before colonoscopic procedures in dogs and cats but specific recommendations for bowel preparation for CT pneumocolonography Veterinary Surgery 45 (2016) 929-935 V C Copyright 2016 by The American College of Veterinary Surgeons are not present in the veterinary literature. Recommendations for bowel cleansing before colonoscopy and biopsy in dogs and cats vary but usually include a combination of an oral cleansing agents (with or without intravenous fluid administration), enemas, and fasting.…”