A randomised trial of hospital versus home administered enemas for flexible sigmoidoscopy

Dear Editor,

Lund et al showed that home administration produced better
preparation scores than hospital administration but were unable to account
for this difference (1). One reason could be that patients receiving their
enema in hospital may be
rushed between the time of administration and their sigmoidoscopy
examination with little time given for complete bowel evacuation. This may
be exacerbated by the patients being inhibited in a generally noisy
hospital environment rather than in the privacy of their own home, where
repeated attempts at complete bowel evacuation may be attempted. 25
patients refused home preparation and in the reasons quoted for refusal,
17 said it seemed too difficult, 7 feared the mess and 2 lacked
understanding of the instructions. It was unclear which group the extra
patient (17+7+2=26) was entered into for analysis.

1) Lund JN, Buckley D, Bennett D et al. A randomised trial of
hospital versus home administered enemas for flexible sigmoidoscopy. BMJ
1998;317:1201.

Yours sincerely,

Andy Huang
Specialist Registrar in General Surgery,
Department of Surgery,
Milton Keynes Hospital,
Standing Way,
Eaglestone,
Milton Keynes MK6 5LD.
Phone:01908-660033
Fax: 0171-486-0883