Efficacy of Prucalopride in bowel cleansing before colonoscopy: Results of a pilot study

Abstract

Colonoscopy is a crucial diagnostic instrument for colorectal cancer screening and an adequate bowel preparation is definitely decisive for the success of the procedure. Especially in elderly patients, bowel cleansing is considered a big issue, because it is often poorly tolerated for many reasons (like inability to swallow large volume of liquids or unlikable taste); this can cause a suboptimal preparation that may lead to miss a neoplastic lesion. There is relatively little data about how to improve preparation tolerability. The purpose of our pilot study was to analyze the effect of prucalopride (Resolor^®), a highly selective serotonin 5HT4 receptor agonist used for chronic constipation for its ability to stimulate gastrointestinal peristalsis, undertaken the day before colonoscopy, followed by half volume of polyethylene glycol solution. We found that this can be a good and safe method to achieve an adequate and better-tolerated colon cleansing.

Keywords: Bowel cleansing; Colonoscopy; Prucalopride; Screening; Colorectal cancer

Core tip: Efficacy of bowel cleansing is of crucial importance in screening colonoscopies for the prevention and early detection of colorectal cancer. Many categories of patients however cannot tolerate the large volume of liquids that make up standard bowel cleansing regimens. Aim of our pilot study was to test the efficacy of prucalopride, a highly selective 5HT4 receptor agonist that increases bowel movements, in improving bowel cleansing and reducing the necessary volume of liquids.