Preoperative bowel preparation with meglumine and sodium diatrizoate (Gastrografin): A prospective randomised comparison

Abstract

Objective: To test the use of meglumine and sodium diatrizoate (Gastrografin) as an agent for preoperative mechanical bowel preparation. Design: Prospective randomised comparison. Setting: County general hospital, Greece. Subjects: 58 patients listed for elective colorectal operations were randomly divided into 2 groups. The first (n = 30) was given Gastrografin 200 ml orally for 2 consecutive days before operation, and the second (n = 28) was given Ringer's solution through a nasogastric tube. Main outcome measures: Tolerability, acceptability, quality of cleansing, and complications. Results: There were no disturbances in electrolyte concentrations, and other laboratory variables also remained unchanged. Two patients treated with Ringer's solution had appreciable increases in arterial blood pressure. but there were no significant overall changes. About half the patients given Ringer's felt nauseated and a third vomited. Such symptoms were uncommon in patients treated with Gastrografin (p < 0.01). 28/30 and 26/28 (93%) had a clean colonic lumen Lit operation, whereas in the reminder the lumen was evaluated as containing "slight residue". There were no operation-related complications. Conclusions: Gastrografin can be used successfully as an agent for mechanical bowel preparation before elective colorectal surgery, as it gives equally good cleansing results compared with the established method of whole gut irrigation. It also seems to be better tolerated and accepted by patients.