Researchers find better way to prep patients for colonoscopy procedures

Henry Ford Health SystemMay 3 2010

Researchers at Henry Ford Hospital may have found a better way to prep patients for colonoscopy procedures so they no longer need to drink a gallon of prescribed fluids prior to the procedure.

The study found that patients who took a pill that is FDA-approved for chronic constipation as part of the colonoscopy prep only needed to drink half of the liquid previously required to cleanse the bowels.

While the combination did not improve polyp detection during the colonoscopy, researchers say it led to improved bowel preparation quality and was better tolerated by patients than the liquid mix of polyethylene glycol (PEG) and electrolytes alone.

"Most people say they don't want to have a colonoscopy because they find the preparation intolerable," says Chetan Pai, D.O., a Henry Ford Hospital gastroenterologist and lead author of the study.

"If physicians are able to offer a better way to prep, I think this will encourage more people to get the colonoscopies that may save their lives."

He explains that approximately 90 percent of colon cancer occurs in people over age 50, but these older adults tend to have difficulty drinking a gallon of electrolytes in preparation for the colonoscopy.

Study results will be presented May 2 at Digestive Diseases Week in New Orleans.

According to the National Cancer Institute, in 2009, more than 146,000 new cases of colon and rectal cancer were diagnosed and nearly 50,000 people died from the disease. However, colon cancer is one of the most preventable forms of cancer because if it is found early through a colonoscopy screening test, it can be stopped before it has spread.

The constipation drug lubiprostone - a chloride pump activator in tablet form - has been used anecdotally in patients unable to tolerate drinking a full gallon of PEG and electrolytes as part of the bowel cleansing preparation for colonoscopy.

To test the effectiveness of lubiprostone as part of colonoscopy prep, Henry Ford conducted a randomized, double-blind and placebo-controlled study of 126 patients.

Researchers looked at the tolerability of the combination of lubiprostone and electrolytes, as well as electrolytes alone, and whether it was possible to reduce the volume of electrolytes required for colon cleansing.