Bowel preparation for colonoscopy using standard<i>vs</i>reduced doses of sodium phosphate: A single-blind randomized controlled study

Koshitani, Tatsuya

doi:10.4253/wjge.v6.i8.379

Cited by 4 publications

(5 citation statements)

References 21 publications

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“…Ideal preparation would rapidly and reliably eliminate all fecal material from the colon without causing any gross or histological alternations of the colonic mucosa[ 21 , 22 ]. Moreover, the preparation would not cause any discomfort and would be safe for the patient[ 23 ]. In this study, 32 tablets of Quiklean ® (1.5 g sodium phosphate per tablet) demonstrated noninferiority over two sachets of Klean-Prep combined with one tablet of 5 mg Dulcolax ® (Klean-Prep/Dulcolax ® ) for colon cleansing before colonoscopy, according to Aronchick Scale scores.…”

Section: Discussionmentioning

confidence: 99%

Noninferiority clinical trial comparing the bowel cleansing efficacy of sodium phosphate tablets (Quiklean^®) with a polyethylene glycol/bisacodyl kit

Hung¹,

Chen²,

Chen³

et al. 2021

WJG

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BACKGROUND Efficient bowel cleansing is essential for a successful colonoscopy, but the ideal cleansing agent, volume, and pharmaceutical dosage form have yet to be determined. Small-volume cleansers enhance patient compliance. AIM To compare the bowel cleansing efficacy of 32-tablet sodium phosphate (Quiklean ® ) with 2-L polyethylene glycol (PEG)/bisacodyl (Klean-Prep/ Dulcolax ® ) under identical dietary recommendations. METHODS This multicenter, randomized, parallel-group, noninferiority clinical trial enrolled 472 outpatients, randomized 456 subjects, and scheduled 442 subjects to undergo colonoscopy (Quiklean ® = 222 and Klean-Prep/Dulcolax ® = 220). After bowel preparation, a colonoscopist performed the colonoscopy with video recorded for rating. The primary efficacy endpoint was the bowel cleansing quality using the Aronchick Scale. The secondary endpoints were the bowel cleansing efficacy of three colon segments, tolerability and acceptability, safety using the Ottawa bowel preparation scale, questionnaires by subjects, and monitoring of adverse events. RESULTS Success rates (Excellent + Good) of the bowel cleansing quality by Aronchick Scale were 98.6% ( n = 205) and 97.6% ( n = 204) in the Quiklean ® and Klean-Prep/Dulcolax ® groups, respectively. Quiklean ® demonstrated noninferiority over Klean-Prep/Dulcolax ® in colon cleansing efficacy. Quicken showed better tolerability and acceptability in the overall experience (was rated as excellent; 24.0% vs 17.2%; P = 0.0016) and the taste of the study preparation (was rated as excellent, 23.1% vs 13.4%; P < 0.0001) than Klean-Prep/Dulcolax ® . Safety profiles did not differ between the two groups. Our data indicate that Quiklean ® is an adequate, well-tolerated bowel cleansing preparation compared with the standard comparator Klean-Prep/Dulcolax ® . CONCLUSION Quiklean ® is sodium phosphate tablets available on Taiwan’s market for bowel preparation; it potentially offers patients an alternative to standard large-volume bowel preparation regimens and may, therefore, increase positive attitudes toward colonoscopies and participation rates.

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Section: Discussionmentioning

confidence: 99%

Noninferiority clinical trial comparing the bowel cleansing efficacy of sodium phosphate tablets (Quiklean^®) with a polyethylene glycol/bisacodyl kit

Hung¹,

Chen²,

Chen³

et al. 2021

WJG

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“…Another study comparing the performance of 30 NaP tablets with 2 L of water to the performance of 50 NaP tablets with 2 L of water showed no significant difference in cleansing efficacy[ 10 ]. In that study, the patients who were allocated to the 30-tablet group took sodium picosulfate the night before the procedure, while the other group did not.…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, it was considered that reducing the number of NaP tablets taken with the determined amount of liquid might improve the tolerability of the preparation without impairing the quality of bowel cleansing. In fact, a report compared 30 NaP tablets with 2 L of clear liquid and 50 NaP tablets with 2 L of clear liquid[ 10 ], and found no difference in the tolerability or quality of bowel cleansing achieved with these preparations.…”

Section: Introductionmentioning

confidence: 99%

Comparing reduced-dose sodium phosphate tablets to 2 L of polyethylene glycol: A randomized study

Ako¹,

Koji²,

Yasutomi³

et al. 2017

WJG

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AIMTo compare the tolerability and quality of bowel cleansing between 2 L polyethylene glycol (PEG) and reduced-dose sodium phosphate (NaP) tablets as a preparation for colonoscopy.METHODSTwo hundred patients were randomly assigned to the PEG or NaP groups at the same ratio. The NaP group patients took 30 tablets with 2 L of clear liquid, while the PEG group patients took 2L of PEG. Tolerability was assessed by a questionnaire about taste, volume, and the overall impression. The bowel cleansing quality was evaluated by colonoscopists.RESULTSAlthough NaP showed better tolerability in terms of taste, volume and overall impression (P < 0.01, P < 0.01 and P = 0.02, respectively), the overall cleansing quality was better in the PEG group (P < 0.01). A subgroup analysis, stratified by sex and age, indicated that NaP was associated with better tolerability and equivalent bowel cleansing quality in females of < 50 years of age.CONCLUSIONDespite the better tolerability, the use of 30 NaP tablets with 2 L of clear liquid should be limited due to its lower cleansing quality; however, in certain cases the regimen may deserve consideration, particularly in cases involving young women.

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“… 5 SPS acts in the colon as a stimulant laxative and increases the frequency and strength of peristalsis thereby causing diarrhoea. 6 However, there are some cases of hyponatremia reported due to its use. Fluid and electrolyte disturbances can occur more commonly in patients with risk factors, such as old age, use of SSRIs and thiazide diuretics, chronic kidney disease, congestive heart failure or with a history of electrolyte abnormalities.…”

Section: Introductionmentioning

confidence: 99%

Frequency of hyponatremia caused by sodium picosulfate solution when used as a bowel cleansing agent for colonoscopy

et al. 2020

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Objective: To determine the frequency of hyponatremia in patients taking Sodium Picosulfate Solution (SPS) solution for bowel preparation prior to colonoscopy and to compare serum sodium levels before and after SPS. Methods: This interventional study was conducted at Dr. Ruth K. M. Pfau, Civil Hospital Karachi between June 2019 to November 2019. Patients undergoing colonoscopy were included in the study. All patients were given SPS. Two samples of blood for electrolytes were taken, one 30 minutes before taking SPS solution and another 30 minutes before colonoscopy. Paired sample t-test was used to determine the difference between serum sodium level before taking the colonoscopy solution and serum sodium level before colonoscopy. Results: Fifty- four patients fulfilling inclusion criteria were included. Out of the 54 patients 28 (51.9%) were males and 26 (48.1%) were females. Mean sodium levels before taking colonoscopy solution was 139.7±3.5 mEq/L and mean sodium level before colonoscopy was 138.9±3.8 mEq/L. The difference between serum sodium level before taking SPS colonoscopy solution and before colonoscopy was found to be statistically insignificant (t (53) = 1.308; p = 0.196). Conclusion: No serious adverse effects were reported in any of our patients. There was no significant difference in the serum sodium level of patients undergoing colonoscopy before taking SPS bowel preparation solution and serum sodium level before colonoscopy. doi: https://doi.org/10.12669/pjms.36.7.2376 How to cite this:Rasheed T, Alvi H, Shaikh MA, Ali FS, Zuberi BF, Subhan W. Frequency of hyponatremia caused by sodium picosulfate solution when used as a bowel cleansing agent for colonoscopy. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2376 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Bowel preparation for colonoscopy using standardvsreduced doses of sodium phosphate: A single-blind randomized controlled study

Abstract: AIM:To evaluate the efficacy of a colonoscopy preparation that utilizes a reduced dose of sodium phosphate (NaP) and an adjunct.

Cited by 4 publications

References 21 publications

Noninferiority clinical trial comparing the bowel cleansing efficacy of sodium phosphate tablets (Quiklean^®) with a polyethylene glycol/bisacodyl kit

Noninferiority clinical trial comparing the bowel cleansing efficacy of sodium phosphate tablets (Quiklean^®) with a polyethylene glycol/bisacodyl kit

Comparing reduced-dose sodium phosphate tablets to 2 L of polyethylene glycol: A randomized study

Frequency of hyponatremia caused by sodium picosulfate solution when used as a bowel cleansing agent for colonoscopy

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Bowel preparation for colonoscopy using standardvsreduced doses of sodium phosphate: A single-blind randomized controlled study

Abstract: AIM:To evaluate the efficacy of a colonoscopy preparation that utilizes a reduced dose of sodium phosphate (NaP) and an adjunct.

Cited by 4 publications

References 21 publications

Noninferiority clinical trial comparing the bowel cleansing efficacy of sodium phosphate tablets (Quiklean®) with a polyethylene glycol/bisacodyl kit

Noninferiority clinical trial comparing the bowel cleansing efficacy of sodium phosphate tablets (Quiklean®) with a polyethylene glycol/bisacodyl kit

Comparing reduced-dose sodium phosphate tablets to 2 L of polyethylene glycol: A randomized study

Frequency of hyponatremia caused by sodium picosulfate solution when used as a bowel cleansing agent for colonoscopy

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Noninferiority clinical trial comparing the bowel cleansing efficacy of sodium phosphate tablets (Quiklean^®) with a polyethylene glycol/bisacodyl kit

Noninferiority clinical trial comparing the bowel cleansing efficacy of sodium phosphate tablets (Quiklean^®) with a polyethylene glycol/bisacodyl kit