PURPOSE:: PURPOSE::Water for colostomy irrigation is largely absorbed by the colon, which may result in less efficient expulsion of stool. This study compared the outcome of colonic cleansing with water and polyethylene glycol solution.
METHODS:: METHODS::In a cross-over study, 41 colostomy irrigators were randomly assigned to water or polyethylene glycol solution irrigation first and then the other regimen, each for one week. Patients recorded fluid inflow time, total washout time, cramps, leakage episodes, number of stoma pouches used, and satisfaction scores (Visual Analog Scale, 1-10: 1 = poor, and 10 = excellent). The median and interquartile range for each variable was calculated, and the two treatments were compared (Wilcoxon's test).
RESULTS:: RESULTS::Eight patients failed to complete the study. Thirty-three patients (20 females; mean age, 55 (range, 39-73) years) provided 352 irrigation sessions: water (n = 176), and polyethylene glycol solution (n = 176). Irrigation was performed every 24, 48, and 72 hours by 17, 9, and 7 patients respectively, using 500 ml (n = 1), 750 ml (n = 2), 1,000 ml (n = 16), 1,500 ml (n = 11), 2,000 ml (n = 2), and 3,500 ml (n = 1) of fluid. The median and interquartile range for watervs. polyethylene glycol solution were: fluid inflow time (6 (range, 4.4-10.8)vs. 6.3 (range, 4.1-11) minutes;P= 0.48), total washout time (53 (range, 33-69)vs. 38 (range, 28-55) minutes;P= 0.01), leakage episodes (2.3 (range, 1.7-3.8)vs. 0.7 (range, 0.2-1);P< 0.001), satisfaction score (5.8 (range, 4-7.5)vs. 8.8 (range, 8.3-10);P< 0.001), and stoma pouch usage per week (75 (range, 45-80)vs. 43 (range, 0-80);P= 0.008). No difference was demonstrated for frequency of cramps (P= 0.24).
CONCLUSIONS:: CONCLUSIONS::Polyethylene glycol solution performed significantly better than water and may be a superior alternative fluid regimen for colostomy irrigation.
Austin O'Bichere was supported by a grant from St. Mark's Hospital/Northwick Park Institute for Medical Research and Dansac Limited.
Poster presentation in part at the meeting of The American Society of Colon and Rectal Surgeons, San Diego, California, June 2 to 7, 2001, and presented at the meeting of the Association of Coloproctologists of Great Britain and Ireland, Harrogate, United Kingdom, June 25 to 27, 2001.
aProfessor of Colorectal Surgery, Level 5 St. Mark's Hospital, Northwick Park/St. Mark's NHS Trust, HA1 3UJ, Harrow, Middlesex, United Kingdom, e-mail: firstname.lastname@example.org
© The ASCRS 2004