Introduction Colonoscopy is the principal therapeutic tool for colorectal cancer prevention. Adenoma removal has been shown to decrease the incidence of colorectal cancer in screened populations. Good visualisation of the entire colonic mucosa is essential for high rates of adenoma detection. The optimal preparation regimen for bowel preparation has not yet been defined.
Methods The aim was to assess the effectiveness of different regimens for bowel preparation, comparing low volume polyethylene glycol (Moviprep, Norgine, UK) with senna and magnesium citrate (Citramag, Sanochemia Diagnostics UK). Split dosing was used for afternoon appointments. All patients received instructions on dietary restrictions before the procedure.
Those undergoing colonoscopy in the first month of the trial were given senna and magnesium citrate; those in the following month were administered Moviprep unless there were contraindications to the intended bowel preparation. The quality of the bowel preparation was independently assessed using the validated 10-point Boston Bowel Preparation Scale (BBPS) by nurses trained in its use.
Results Patients who had undergone segmental colectomy were excluded. In total, 580 eligible procedures were performed. 251 patients received Moviprep; 326 were given senna and Citramag. Bowel cleansing with Moviprep was statistically superior in each assessed segment of the colon as well as overall (mean score 6.56, p = 0.027). Patients given Moviprep were more likely to have a perfect preparation score of 9 (p < 0.001). The reasons for failure in patients who were not fully imaged were recorded. 3 procedures were aborted due to poor bowel preparation; all of these patients received Moviprep (p = 0.08). The patient-assessed taste of Moviprep was significantly worse than senna and Citramag (P < 0.001). There was no significant difference between both groups with regards to age, sex or percentage of patients who finished the preparation (p = 0.14).
Conclusion These data – the largest in the literature comparing these two preparations – show that both produce acceptably high levels of bowel cleansing for colonoscopy. Moviprep appears to cleanse slightly better throughout the colon but was judged by patients to be less palatable.
Disclosure of Interest K. Patel Grant/Research Support from: Norgine provided the Moviprep gratis. No input into study design, data collection, analysis, or writing of the abstract., R. Fofaria: None Declared, S. Thomas-Gibson: None Declared, B. Saunders: None Declared
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