Journal Club: July 2010

Can Assoc Radiol J. 2010 Jul 8. [Epub ahead of print]

Bowel Preparation Suitable for Same Day Computed Tomography Colonography and Colonoscopy.

Eddy M, Stevenson G, Mathieson J, Behrens C, Eddy R.


PURPOSE: This study was designed to evaluate whether a bowel preparation used for computed tomography (CT) colonography could also be suitable for same-day colonoscopy regardless of which test was done first.

METHOD: Six different endoscopists working at 3 separate hospitals evaluated 75 patients who underwent colonoscopy after receiving a bowel preparation that contained contrast material used to tag fecal and fluid material to facilitate CT colonography. This bowel preparation has been used in more than 1500 CT colonography studies. Evaluation included assessment of whether the colon was clean and dry, and whether the contrast material caused any impairment of visualization or clogging of the endoscopes. Some of the patients had first undergone CT colonography followed by same-day colonoscopy, whereas other patients had colonoscopy as their initial test.

RESULTS: Although the contrast material was sometimes perceptible, the volumes were very small, and caused no impairment of mucosal visualization and no clogging of the endoscopes. The bowel preparation was well tolerated. Same-day CT colonography and colonoscopy with fecal tagging was technically possible.

CONCLUSION: A simple, fairly low cost 1-day bowel preparation with fluid and fecal tagging is suitable for CT colonography and colonoscopy done the same day in either order. However, the preferences of individual endoscopists and difficulties with making oral contrast agents readily available are challenges to widespread adoption of a common bowel preparation regimen.