Optimal bowel preparation for flexible sigmoidoscopy—Are two enemas better than one?

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

“…This method seemed safe, simple, and cheap, but its efficacy with regards to the quality of bowel preparation and patient acceptability had not been assessed. Previously several randomized studies had favoured the use of a single Fleet enema [5][6][7][8]. We, therefore, conducted a prospective randomized trial comparing the use of glycerin suppositories versus a single Fleet enema for bowel preparation prior to the flexible sigmoidoscopy in an attempt to evaluate their efficacy and patient acceptability.…”

Single blind, randomised trial of efficacy and acceptability of oral Picolax versus self administered phosphate enema in bowel preparation for flexible sigmoidoscopy screening Commentary: participants should have been told they were being randomised Commentary: opportunity for patient partnership was lost

“…Two sachets of Picolax are used routinely for colonoscopy, but a single sachet is used for flexible sigmoidoscopy 4. A single phosphate enema is as effective as two enemas for sigmoidoscopy 3 5. The two preparations were compared in two separate populations to determine whether the findings could be generalised throughout the United Kingdom.…”

Rigid or Flexible Sigmoidoscopy in Colorectal Clinics? Appraisal Through a Systematic Review and Meta-analysis

“…25 For rigid sigmoidoscopy two self-administered suppositories have been shown to improve the view, whereas a single phosphate enema is considered adequate for flexible sigmoidoscopy. [26][27][28] Rigid sigmoidoscopy performed in the clinic would not necessarily give a clue of underlying pathology. Flexible sigmoidoscopy, on the other hand, has been demonstrated to reduce the mortality from colorectal cancer when performed only once in the older age group.…”