A prospective randomized controlled clinical trial comparing three forms of cleansing enema for rigid proctosigmoidoscopy

The aim of this study was to compare the efficacy of three forms of cleansing enema for rigid proctosigmoidoscopy. One hundred fifty five patients referred for proctosigmoidoscopy to the Department of Surgery at the FEU-NRMF Medical Center were randomly assigned by simple random sampling into three groups to receive three forms of cleansing enema: monobasic sodium phosphate dibasic sodium phosphate (Fleet Enema ) for Group 1 (n=42), sorbitol and dioctyl sulfosuccinate ( Clyss Go) for Group 2 (n=38) and soap sud enema (SS Enema) for Group 3 (n=45). Quality of bowel preparation was graded as good, fair or poor. The cleansing enema was administered one hour prior to the procedure. It was readministered in case the patient did not have bowel movements. Another dose of the designated enema was given if the bowel preparation was poor. The reinfusion rate for the SS enema group was only 17 percent, significantly lower than the 45 percent of the Fleet Enema group (p=0.01), but not statistically different from the 39 percent of the Clyss Go group (p=0.05). The cost-effective analysis using direct costs showed SS enema was more cost- effective than Fleet Enema or Clyss Go enema. The SS enema was a good alternative for cleansing the bowel prior to rigid proctosigmoidoscopy. It had a low reinfusion rate and was more cost-effective than Fleet enema or Clyss Go. (Author)

Use of locally innovated radiopaque markers (MAKKO pills) for colonic transit study

Locally made radiopaque markers for colonic transit study are presented, specifically on how they were made, and how they compared radiographically with markers available abroad. These markers were produced using locally available materials like barium powder, a feeding tube, cyanoacrylate, and emptied drug capsules. They were then ingested and monitored by X-ray. They were found to be radiographically comparable with imported ones. No adverse events were noted when used in 5 patients: 2 patients with constipation secondary to chronic laxative abuse, 2 patients with reducible complete rectal prolapse, and 1 patient with constipation secondary to short segment Hirschsprungs' Disease. (Author)