Effective colonoscopy relies on adequate bowel cleansing. Now, two new papers published in Endoscopy show that a novel colon cleansing system is a safe and effective means to improve cleaning of the colon prior to colonoscopy.

Suboptimal cleansing impairs both the efficacy and safety of colonoscopy, leading to, among other issues, poor visualization of the intestine and possible missed diagnosis. Here, two different research groups trialled a new disposable catheter cleansing device (JetPrep) that fits through the colonoscope channel to enable irrigation to flush debris out of the colon.

Both studies enrolled patients who had been referred for colonoscopy but had, despite bowel preparation with either polyethylene glycol or sodium sulphate, at least one inadequately cleansed bowel segment. Patients were then split equally between two groups: the investigation group who had JetPrep irrigation; and the control group who had standard syringe irrigation.

Eliakim and colleagues enrolled 38 patients in total to their study, 19 in each arm. Overall, improvements in cleansing were greater in the JetPrep group than the control group; the cleansing grade improved by 0.74 points in the investigation group compared with only 0.19 points in the control group (P <0.0001). Moreover, the improvements in right colon cleansing were also statistically significant in the JetPrep versus control group (P <0.0001). No adverse events and no differences in the duration of the procedure were reported.

The authors of the second study found similar improvements in colon cleansing with the new system. With 21 patients in each study group, Rigaux et al. found that JetPrep was again superior to syringe irrigation (mean improvement in cleansing grade of 0.99 versus 0.55, respectively), with statistically significant improvements in cleansing of the right colon. As before, the procedure time was similar between the different cleansing approaches, and no adverse events were reported.

Both sets of researchers note 'cautious optimism' with respect to the new JetPrep cleansing system, but stress that further larger studies are needed to verify and support these latest findings.