Whole gut irrigation: an inadequate preparation for double contrast barium enema examination
Bakran, A.; Bradley, J.A.; Bresnihan, E.; Lintott, D.; Simpkins, K.C.; Goligher, J.C.; Hill, G.L.
Gastroenterology 73(1): 28-30
1977
ISSN/ISBN: 0016-5085 PMID: 863198 Document Number: 119653
A clean large bowel is a prerequisite for successful Ba enema examination. Outpatients (20) of similar age, sex distribution and symptomatology presenting for Ba enema examination by a modification of the Malmo double contrast technique were randomly allocated to 2 groups. The normal preparation group ate a restricted diet and took a laxative the day before. Immediately before the examination the colon was washed out using colonic lavage. The irrigation group omitted the laxative. The colon was cleansed with warmed isotonic saline which was infused down a nasogastric tube until the effluent was clear or 10-12 l were infused. The average amount infused was 10.5 .+-. 1.1 l over a mean time of 1.64 .+-. 0.2 h. The examinations were performed by 1 radiologist. Three radiologists (without knowledge of the preparation used) independently assessed all radiographs according to the amount of water and feces remaining, the quality of mucosal coating, the amount of Ba present, and terminal ileum filling. When the results of the 3 radiologists were pooled, mucosal coating and definition were found to be significantly worse in the irrigated patients (P < 0.025 Mann-Whitney u-test). There were also significant increases in residual water, amount of Ba present in the colon, and terminal ileum filling (P < 0.05) in the irrigated patients, although no difference was noted in the amount of residual feces. The whole gut irrigation is not a satisfactory preparation for double contrast Ba enema examination.