A new colonic lavage system to prepare the colon for colonoscopy: A retrospective study

Background: One of the most unpleasant and sometimes difficult elements of colonoscopic examination is the bowel preparation which is usually performed 6 or more hours prior to the examination ("early" preparation), causing many patients to refrain from undergoing this procedure. We present a novel technique for bowel preparation that begins approximately 30 min prior to the introduction of the colonoscope and eliminates the need for significant preprocedure preparation. Methods: The medical records of all consecutive patients who underwent colonoscopy without "early" preparation (CWEP) from May 2009 through June 2010 were retrospectively reviewed. The procedure was performed using a novel cleansing device, the "ColonoScoPrepTM", with which the colon is prepared about half an hour prior to insertion of the colonoscope. The only medication required is two to three bisacodyl tablets the night before. The quality of bowel preparation was graded as excellent, good, satisfactory, or poor, and patient satisfaction was assessed according to a prospective protocol. Results: During this period, 125 patients underwent CWEP. Of these, 110 (89.4 %) patients had an excellent or good preparation, permitting complete colonoscopic examination unimpeded by fecal matter. In 11 patients, preparation was satisfactory, in 2 it was poor and in 2, colonoscopy was not completed due to unsatisfactory preparation. None of the patients suffered from abdominal pain or cramps during or after the CWEP and none had post-colonoscopy diarrhea. All patients were satisfied with the procedure. Conclusions: Despite the fact that the study is retrospective, CWEP appears safe and easy to perform. A prospective study comparing conventional bowel preparation and CWEP is now underway.