Background Flexible sigmoidoscopy is a popular method for examining the left side of the colon, but adequate bowel cleansing is critical for detection of mucosal abnormalities, and for minimising the number of repeat procedures. It has, however, long been debated which method, oral preparation or enema, gives the best results.
Aim At our unit both oral and phosphate enema preparations are utilised, and we therefore wanted to find out which type of preparation gives best results.
Methods Patients who underwent flexible sigmoidoscopy from 1st February to 31st July 2016 were retrospectively reviewed using our endoscopy reporting system. Their demographics and the individually achieved quality of bowel preparation (subjectively graded as: Excellent, Adequate or Inadequate) were analysed. A chi-squared test was used calculate p-values.
Results 1054 patients underwent flexible sigmoidoscopy during the study period, of whom 822 were included in this study, after excluding 232 patients (22.01%) due to: no bowel preparation (n=69), no documentation of quality of bowel preparation (n=151) and other reasons (n=12). 494 (46.87%) patients (males 248 (50.20%), mean age 60.48 years, range 15-94 years) had oral preparation with low volume polyethylene glycol-electrolyte solution (PEG-ELS), and 491 (46.58%) (males 245 (49.90%), mean age 65.49 years, range 18-98 years) had phosphate enema. The outcomes are summarised in the table below.
Conclusions Our relatively large retrospective study showed that oral preparation with PEG-ELS resulted in significantly better bowel preparation compared to phosphate enema. PEG-ELS is now the preferred option in our unit where there is no contraindication for this.