A national study to compare the tolerability and effectiveness of colon cleansing preparations.

摘要

Colorectal cancer is the third most common form of cancer, and the second leading cause of cancer-related deaths in the United States. Fortunately, 90% of colorectal cancer deaths are preventable if the disease is detected early. Colonoscopy, the gold standard for colorectal cancer screening, allows direct examination of the colon. However, the colon must be cleaned of all stool in order to detect polyps, tumors, inflammation, and other problems. A wide variety of purging agents are available for colon cleansing but all have limitations and poor bowel cleansing is common. The purpose of the study was to (1) describe bowel cleansing preparations being used across the country, (2) compare their cleansing effectiveness and tolerability, and (3) compare their effectiveness in patients with various health characteristics. This prospective, comparative, descriptive design used convenience sampling to collect data from adult patients scheduled for colonoscopy at four sites (Baltimore, MD; Dallas, TX; Grand Prairie, TX; and Seattle, WA). Three instruments were used to collect data about tolerability of the colonoscopy preparations, colon cleanliness and demographic and other background information. 201 participants were used for data analysis. The findings revealed many preparations are being used in data collection. More intensive preparations are being used. The preparations were good to excellent with 4 liter (L) PEG-ES with the addition of bisacodyl tablets and MoviPrep demonstrating more of the preparations with excellent ratings. Patients did experience a variety of symptoms which included full feeling, fatigue, abdominal pain, and nausea. Patients also reported sleep disturbances and difficulty with the preparation. There was no statistical significance in colon cleanliness among patients with long standing constipation, diabetes, thyroid disease, or depression. Older age patients did have an increase in their cleanliness scores. It is important to continue pooling data from different sites to help in tailoring preparations to specific patient populations. Additional research may assist nurses in developing guidelines for an individualized approach in selecting colon cleansing preparations which are safe and effective.