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Right Colon Enema to Improve Bowel Preparation Quality During Colonoscopy
Sponsor: Westmead Hospital
Summary
Colonoscopy is a test that lets doctors look inside the large bowel to find and remove growths called polyps, which can develop into bowel cancer. Before the test, people take a bowel preparation to empty the bowel. Even so, the right side of the bowel is often not clean enough, and polyps there can be missed. This study is testing whether giving an enema (a small amount of fluid passed into the bowel) during the colonoscopy makes the right side of the bowel cleaner. Participants having a routine colonoscopy at Westmead Hospital or Auburn Hospital will be assigned by chance to either receive the enema during the procedure or to have their colonoscopy in the usual way. Neither group takes any extra preparation at home. The researchers will compare how clean the right side of the bowel is in each group, using a standard scoring system, and will also look at how many polyps are found. The aim is to find out whether this simple step improves the quality of colonoscopy.
Official title: RIGHT-CLEAN Trial: A Multi-centre Randomised Controlled Trial of Intra-procedural Right Colon Enema Versus no Enema to Improve Total Colonic Bowel Preparation at Colonoscopy.
Key Details
Gender
All
Age Range
18 Years - 85 Years
Study Type
INTERVENTIONAL
Enrollment
320
Start Date
2026-11-01
Completion Date
2028-11-01
Last Updated
2026-09-24
Healthy Volunteers
Yes
Interventions
Sodium phosphate enema
A single Fleet sodium phosphate enema (monobasic sodium phosphate monohydrate 19 g and dibasic sodium phosphate heptahydrate 7 g in 118 mL of saline) is administered once, intra-procedurally, into the right colon through the colonoscope working channel after confirmed caecal intubation. The enema nozzle is aligned with the working channel for delivery. The volume instilled is recorded and is not counted towards intra-procedural water-jet lavage. No further doses are given.
Water instillation
Immediately after confirmed caecal intubation and randomisation, with the colonoscope tip in the right colon, 100 mL of water is instilled into the right colon through the colonoscope working channel using a syringe. All subsequent steps are identical to the intervention arm: the right colon is refilled to the hepatic flexure using the foot-pump water jet, the fluid is not suctioned, the right lower quadrant is agitated by manual percussion, and the lumen is re-insufflated with CO2 before the scope is returned to the caecum for withdrawal.
Locations (2)
Auburn Hospital
Auburn, New South Wales, Australia
Westmead Hospital
Westmead, New South Wales, Australia