Osmotic or purgative based laxatives, which gives the best prep? Need much tighter prep compared with optical colonoscopy
Angus, I don't know whether this the optimal or not. But we and Royal Free follow the below regime
1. A split dose of Moviprep for bowel cleansing.
2. Boosters-
1st booster- Gastrografin (50ml) and Fleet (30 ml) in 1L of water. On small bowel detection
2nd booster- Gastrografin (50ml) and Fleet (15ml) in 500 ml of water. 3 hours after 1st booster (around 50% of patients need this)
3rd booster- 10mg bisacodyl suppository. Two hours after the 2nd booster if the test still isn’t complete
Hi, Angus,
I’m afraid there is not such a thing like the “optimal bowel prep” capsule colonoscopy.
The prep reported by Thaha is a variant of Spada C et al, Gut 2015 Feb;64(2):272-81, where actually 2L plus 2L more of PEG were administered to patients. Gastrografin is used off-label.
The standard prep is reported in the ESGE guideline: Spada C et al, Endoscopy 2012;44:527-536. You may also use a low-volume prep, with good results, as reported in HartmannD et al, Endoscopy 2010;44;482-486.
At our center we are happy with a low volume prep (2L Moviprep) given as same day prep starting at 07:00. The capsule is ingested at 08:45. We use as boosters 35 mL of Phospho-soda (on small bowel detection) followed by other 25 mL of booster at 3 hours, if necessary. Overall colon cleanliness is excellent or good in 80% of cases, irrespective of patient’s age and gender. Expulsion is around 5 hours, with an overall capsule excretion rate of 90%.
It is ummarised simply at :
http://www.westgeorgiagastro.com/prep-small-bowel.php
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