Comparison the Effectiveness of Original Castor Oil and Herbal Castor Oil for Bowel Preparation Prior to Buriam Enema: A Prospective Randomized Clinical Trial

Abstract

Background: Barium enema is a special radiological study for colonic evaluation. Bowel cleaning preparation is usually given castor oil two days before radiologic procedure. However, patient discomfort and castor oil intolerance was major factor for inadequate bowel preparation in which colonic preparation failure rate in year 2014 and 2015 were 28.2% were 38.1% respectively. Therefore a new herbal castor oil formulation was developed.
Objective: To compare efficacy of original castor oil and herbal castor oil in complete bowel preparation rate, patients’ satisfaction and patient intolerance before the barium enema.
Setting: Radiology Department, Buriram Hospital
Population: Patients who were scheduled for barium enema in Buriram Hospital aged between 18 to 85 years. Data was collected during July to December 2016.
Methods: The prospective randomized control trail was conducted. Patients were randomized into two groups, control group was given with with 60ml original castor oil and experimental group was given with 60 ml herbal castor oil two day before intervention. Complete colonic preparation was evaluated from fecal residual by radiologists. Patient’s satisfaction, success rate and medication intolerance were recorded on the appointment date by Likert scores. Patient’s characteristics such as age, gender, diagnosis, history of constipation and side effect of drug were collected. Student t-test, chi square and descriptive analysis were used for statistical analysis.
Results: There were 100 patients enrolled to this study, results showed no significant difference in amount of fecal residual in colon (P=007), patient’s satisfaction and medication intolerance (P=0.20) between two groups.
Conclusion: Herbal castor oil formulation was more effective in reducing fecal residual in colon than original castor oil and also had better patient’s satisfaction and well tolerance. This study suggested that herbal castor oil is useful for bowel preparation before barium enema.