A prospective randomized single blind trial of Fleet phosphate enema versus glycerin suppositories as preparation for flexible sigmoidoscopy

This study compared the efficacy and patient acceptability of two methods of bowel preparation for flexible sigmoidoscopy.

Patients attending for outpatient flexible sigmoidoscopy were prospectively randomized to receive one Fleet ready-to-use enema or 2 × 4 g glycerin suppositories, 2 h preprocedure. Patient and endoscopist questionnaires were used to compare the outcomes.

From November 2000 to August 2001, 203 (male = 95; female = 108) patients were randomized. Patient data available for 163 patients (enema = 93; suppository = 70) revealed: ease of use (enema = 52; suppository = 25; P < 0.02, Fisher’s exact); assistance required (enema = 19; suppository = 3; P < 0.005, Fisher’s exact); grade of effectiveness (enema = 83; suppository = 44; P < 0.0001, Fisher’s exact), and whether patients wished to try another preparation in future (enema = 16; suppository = 24; P = 0.016, Fisher’s exact). Endoscopist data available for 151 patients (enema = 76; suppository = 75) revealed: average depth of insertion (enema = 53.6 ± 11.6 cm; suppository 46.3 ± 13.7 cm; P < 0.001, Student’s t test); acceptable (excellent + good) quality of preparation [enema = 60 (78.9%); suppository = 34 (45.3%); P < 0.0001, Fisher’s exact].

Bowel preparation for flexible sigmoidoscopy using a single Fleet enema is acceptable to patients and more effective than glycerin suppositories.