A Randomized, Multicenter Study Comparing the Safety and Efficacy of Sodium Phosphate Tablets With 2L Polyethylene Glycol Solution Plus Bisacodyl Tablets for Colon Cleansing

Abstract

The colon-cleansing efficacy of the new 32-tablet NaP dosing regimen in this study was found to be significantly better than the 2L PEG solution plus bisacodyl tablets regimen. The 32-tablet NaP dosing regimen was associated with fewer adverse events. As expected electrolyte shifts were more common and of greater magnitude in the NaP group compared with the PEG plus bisacodyl group; however, both treatment groups demonstrated significant changes in electrolytes and creatinine.

Randomized controlled trial of low-volume bowel preparation agents for colonic bowel preparation: 2-L polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate

“…Cleansing in the right colon is particularly important because flat polyps have significant premalignant potential and are found preferentially in the right colon [23,24]. However, bowel cleansing of the right colon is difficult because of concealment by opaque small-bowel effluent such as mucus and chime [25,26]. In the current study, when comparing the cleansing efficacy between 2-L PEG/Asc and SP/MC groups according to colon segment as well as the entire bowel, the mean BBPS scores for each segment including the right colon were adequate and comparable between the groups.…”

Adverse Renal and Metabolic Effects Associated with Oral Sodium Phosphate Bowel Preparation

“…Recommendations for volume repletion with OSP preps vary from 0.7 to 2.2 L (Fleet currently recommends a "minimum" of 72 oz), but the optimal amount may exceed 3.7 L (98,99). Even carefully selected patients who were given explicit instructions for oral hydration and were studied in the setting of a clinical trial lost an average of 2.3 lbs of body weight after sodium phosphate bowel prep, although weight loss has also been observed with the combination of PEG-ELS ϩ bisacodyl (4,94). In addition, the benefits of increased water intake need to be balanced against the risk of hyponatremia (23,25,26).…”

“…The diagnostic accuracy and cost-effectiveness of colonoscopy are closely related to the quality of the colon preparation, and yet methods to safely, effectively, quickly, comfortably, and affordably prepare the colon remain elusive (3). In clinical trials, nearly 75% of subjects undergoing bowel preparation report adverse events, most commonly abdominal distention, nausea, vomiting, abdominal pain, and dizziness (4).…”

“…A recent meta-analysis concluded that OSP preps result in better bowel cleansing, perhaps because patients are more likely to complete them (13). An industry-sponsored study that compared OSP tablets with PEG-ELS ϩ bisacodyl concluded that OSP is more efficacious and better tolerated (4).…”

Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation

“…Unfortunately, none of the preparations meets all of the requirements [2][3][4] . Several studies have evaluated the efficacy and side effects of regimens for bowel preparation [3][4][5][6][7][8][9][10][11][12][13][14] . In 2006, three medical organizations (the American Society for Gastrointestinal Endoscopy, the American Society of Colon and Rectal Surgeons, and the Society of American Gastrointestinal and Endoscopic Surgeons) suggested that polyethyleneglycol (PEG) should be a gold standard for colonoscopic bowel preparation (Grade IA), and aqueous sodium phosphate (NaP) was an alternative regimen to PEG solution (Grade IA) [2] .…”