Prospective, Randomized Comparison of Castor Oil and Sodium Phosphate Preparation for Barium Enema
Piyaporn Apisarnthanarak MD*, Benjaporn Rotjanaaree MD*, Chulalak Komoltri DrPH**, Aphinya Charoensak MD*, Anucha Apisarnthanarak MD***, Narumol Srisuthapan Hargrove MD*
Affiliation : * Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Research Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Division of Infectious Diseases, Thammasart University Hospital, Pathumthani, Thailand
Objective : To compare castor oil and sodium phosphate preparation (Swiff) in patients’ satisfaction, efficacy
for colon cleanness, side effects, and prices.
Material and Method: One hundred patients referred for barium enema were randomized to receive castor oil
(n = 50) and sodium phosphate preparation (n = 50). They graded their satisfaction using a 5-point scale
(easy, acceptable, slightly difficult, extremely difficult, and unacceptable). The efficacy for colon cleanness
was graded by two radiologists using a 5-point scale (excellent, easy for evaluation, acceptable, difficult for
evaluation, and unacceptable). Side effects were evaluated by patients’ vital signs, total number of bowel
frequency, and 10 associated symptoms.
Results : Both preparations revealed no difference in patients’ satisfaction (p = 0.882) and efficacy of colon
cleanness (p = 0.130). Sodium phosphate preparation was more expensive (79 vs. 10 Baht) and caused higher
number of bowel frequency (p < 0.001).
Conclusion : With a cheaper price, castor oil was comparable with sodium phosphate preparation in patients’
satisfaction and efficacy of colon cleanness.
Keywords : Barium sulfate, Castor oil, Cathartics, Colon, Enema, Phosphates, Sodium phosphate
