ABSTRACT
BACKGROUND: Bowel preparation is a significant aspect of the flexible sigmoidoscopy procedure. Clear visibility of the bowel mucosa is critical for a thorough examination. The combination of a light breakfast in the morning and the application of 2 phosphate enemas a few hours before the examination is a safe and commonly used method of preparing a patient for a flexible sigmoidoscopy procedure. However, there is a paucity of objective data on the efficacy of this method of bowel preparation. It has been practiced on the basis of intuition and clinical experience. METHODS: In this prospective single-blinded randomized study, 429 consecutive patients were assigned to receive 1 of 4 different bowel preparations before elective 60-cm flexible sigmoidoscopy. After completion of the procedure, the examiner gave a subjective rating of the quality of the preparation. The rating was determined on the basis of the percentage of bowel mucosa that was visible. RESULTS: Statistical analysis of results suggests no significant difference in frequency of favorable ratings between the 4 bowel preparations. CONCLUSIONS: This study substantiates the practice of having a light breakfast and 2 phosphate enemas as a method of bowel preparation for a flexible sigmoidoscopy procedure. Additional preparatory measures such as dietary restrictions and ingestion of phospho-soda oral saline laxative did not significantly enhance the quality of the examination.