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Colonoscopy Preparation Optimization for INpatients- COIN Study

Phase 4
Conditions
Endoscopy
Bowel Preparation Solutions
Interventions
Registration Number
NCT01627171
Lead Sponsor
St. Joseph's Healthcare Hamilton
Brief Summary

Colonoscopic examinations are performed routinely in hospitalized patients for a variety of indications. However, numerous limitations exist in hospitalized patients preventing an endoscopist from performing high quality examinations; possibly necessitating repeated procedures leading to increased cost and re-exposure to their inherent risks. One such prominent challenge lays in the adequacy of bowel cleansing. Inpatient status has been shown to be a predictor of poor bowel preparation as these patients are older, less mobile and have more co morbidities than the outpatient population. Currently, no standardized (or optimized) bowel preparation type or regimen for administration exists for the hospital inpatient population undergoing colonoscopy. Studies in the outpatient population have demonstrated that timing and choice of cathartic medication effects the cleanliness of the bowel preparation but there is no such clinical evidence for in-patients who receive whatever cathartic agent is on hospital formulary. The purpose of the study is compare efficacy, patient satisfaction, and adverse effects associated with low volume cathartic (Pico-Salax) to the current standard volume 4 liter (PEG-Lyte) and the effect of alternate timing of dosages.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
126
Inclusion Criteria
  • Inpatient colonoscopy
  • Age greater than 18 years old
  • Able to give consent
Exclusion Criteria
  • No consent obtained
  • Pregnancy or lactating
  • Renal impairment
  • Severe CHF (NYHA class 3/4)
  • Recent myocardial infarction (preceding 6 months)
  • Ileus
  • Ascites
  • Severe Colitis
  • Toxic Megacolon
  • Gastrointestinal Obstruction
  • PEG tube
  • Previous large bowel resection
  • Allergy to study drug

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Pico Salax SplitBisacodyl 10mgTwo sachets of Pico-Salax with 1 taken the night before colonoscopy and the second taken the morning of colonoscopy.
PEG LyteBisacodyl 10mgPEGlyte to be reconstituted with 4L of water and taken in the evening before the colonoscopy.
PEG LytePolyethelene GlycolPEGlyte to be reconstituted with 4L of water and taken in the evening before the colonoscopy.
Pico Salax SplitPicosulfate sodiumTwo sachets of Pico-Salax with 1 taken the night before colonoscopy and the second taken the morning of colonoscopy.
Pico Salax Night BeforeBisacodyl 10mg2 sachets of Pico Salax mixed with water taken about 4 hours apart the night before colonoscopy
Pico Salax Night BeforePicosulfate sodium2 sachets of Pico Salax mixed with water taken about 4 hours apart the night before colonoscopy
Primary Outcome Measures
NameTimeMethod
Ottawa Bowel Prep Score30 minutes after procedure

Using a standardized, validated score for measuring quality of bowel preparation

Secondary Outcome Measures
NameTimeMethod
Procedures Cancelled or repeated due to inadequate bowel preparationDuring admission (average of 2 weeks)

If bowel preparation is deemed inadequate to the point the procedure must be cancelled or rescheduled

Individual Components of Ottawa Bowel Prep Score30 minutes after procedure

Each section of prep score evaluating the right, mid, and left colon, as well as the fluid score will be analyzed individually

Adverse EffectsUp to 48 hours after procedure

Any adverse effects that may be attributed to the intervention

Tolerability of the preparationWithin 1 day of intervention

A questionnaire to assess the overall tolerability of the preparation.

Trial Locations

Locations (1)

St Joseph Hospital

🇨🇦

Hamilton, Ontario, Canada

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