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Randomized Controlled Trial
. 2007 May 4:7:5.
doi: 10.1186/1471-2482-7-5.

Preoperative mechanical preparation of the colon: the patient's experience

Barbel Jung  1 , Olof Lannerstad, Lars Påhlman, Malin Arodell, Mitra Unosson, Erik Nilsson
Affiliations
Randomized Controlled Trial

Preoperative mechanical preparation of the colon: the patient's experience

Barbel Jung et al. BMC Surg. .

Abstract

Background: Preoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials.

Methods: As part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There were 39 questions, each having 3 - 10 answer alternatives, dealing with food intake, pain, discomfort, nausea/vomiting, gas distension, anxiety, tiredness, need of assistance with bowel preparation, and willingness to undergo the procedure again if necessary.

Results: 60 patients received mechanical bowel preparation (MBP) and 45 patients did not (No-MBP). In the MBP group 52% needed assistance with bowel preparation and 30% would consider undergoing the same preoperative procedure again. In the No-MBP group 65 % of the patients were positive to no bowel preparation. There was no significant difference between the two groups with respect to postoperative pain and nausea. On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02. Time to intake of fluid and solid food did not differ between the two groups. Bowel emptying occurred significantly earlier in the No-MBP group than in the MBP group, p = 0.03.

Conclusion: Mechanical bowel preparation is distressing for the patient and associated with a prolonged time to first bowel emptying.

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Figures

Figure 1
Figure 1
Height of boxes represents median of experienced discomfort on Days 1, 4 and 7 postoperatively, measured as value on a ten point Numerical Rating Scale. Vertical bars represent inter-quartile range. P < 0.05 considered significant (t-test).
Figure 2
Figure 2
Height of boxes represents median of experienced nausea on Days 1, 4 and 7 postoperatively measured as value on a ten point Numerical Rating Scale. Vertical bars represent inter quartile-range. P < 0.05 considered significant (t-test).
Figure 3
Figure 3
Height of boxes represents median of experienced pain on Days 1, 4 and 7 postoperatively measured as value on a ten point Numerical Rating Scale. Vertical bars represent inter-quartile range. P < 0.05 considered significant (t-test).
See this image and copyright information in PMC

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