Effects of oral sodium picosulphate Picolax® on urea and electrolytes

Ryan, Fran; Anobile, Tina; Scutt, Diane; Hopwood, Marion; Murphy, G. M.

doi:10.7748/ns.19.45.41.s51

Cited by 11 publications

(10 citation statements)

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“…This is a factor that is well known to positively influence efficacy rate. 14 Our data also confirmed both adult and pediatric data on the safety of NaPico +MgCit compared with PEG-ELS 11,[15][16][17] and, for the first time in a pediatric population, with 2 low-volume PEG solutions (PEG-CS+bisacodyl and PEGAsc). Indeed, in our series there was no statistically significant difference in the incidence of dehydration or in preand posttreatment laboratory values of kidney and liver function and serum 2 test.…”

Section: Discussionsupporting

confidence: 79%

Bowel Preparations for Colonoscopy: An RCT

et al. 2014

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BACKGROUND: The ideal preparation regimen for pediatric colonoscopy remains elusive, and available preparations continue to represent a challenge for children. The aim of this study was to compare the efficacy, safety, tolerability, and acceptance of 4 methods of bowel cleansing before colonoscopy in children. METHODS: This randomized, investigator-blinded, noninferiority trial enrolled all children aged 2 to 18 years undergoing elective colonoscopy in a referral center for pediatric gastroenterology. Patients were randomly assigned to receive polyethylene glycol (PEG) 4000 with simethicon (PEG-ELS group) or PEG-4000 with citrates and simethicone plus bisacodyl (PEG-CS+Bisacodyl group), or PEG 3350 with ascorbic acid (PEG-Asc group), or sodium picosulfate plus magnesium oxide and citric acid (NaPico+MgCit group). Bowel cleansing was evaluated according to the Boston Bowel Preparation Scale. The primary end point was overall colon cleansing. Tolerability, acceptability, and compliance were also evaluated. RESULTS: Two hundred ninety-nine patients were randomly allocated to the 4 groups. In the per-protocol analysis, PEG-CS+Bisacodyl, PEG-Asc, and NaPico+MgCit were noninferior to PEG-ELS in bowel-cleansing efficacy of both the whole colon (P = .910) and colonic segments. No serious adverse events occurred in any group. Rates of tolerability, acceptability, and compliance were significantly higher in the NaPico+MgCit group. CONCLUSIONS: Low-volume PEG preparations (PEG-CS+Bisacodyl, PEG-Asc) and NaPico+MgCit are noninferior to PEG-ELS in children, representing an attractive alternative to high-volume regimens in clinical practice. Because of the higher tolerability and acceptability profile, NaPico+MgCit would appear as the most suitable regimen for bowel preparation in children.

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Section: Discussionsupporting

confidence: 79%

Bowel Preparations for Colonoscopy: An RCT

et al. 2014

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“…Full laxative bowel preparation is arduous for any individual [5], but it has risks for elderly people or those with comorbidity [6,7], with adverse effects including bowel perforation [8]. MPCT colon is promoted by its advocates as a safe and well-tolerated test for colon cancer, although its sensitivity is less than other modalities.…”

Section: Discussionmentioning

confidence: 99%

Gas insufflation of minimal preparation CT of the colon reduces false-positives

Slater

North²,

Hart³

et al. 2012

BJR

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Objectives: Minimal preparation CT of the colon (MPCT colon) is used for investigation of suspected colorectal cancer in frail and/or elderly patients who would be expected to tolerate laxative bowel preparation poorly. Although it has good sensitivity for colorectal cancer it has a poor specificity. We wished to investigate whether distension of the colon with carbon dioxide alone would reduce the number of false-positives, but without making the test arduous or excessively uncomfortable. Methods: 134 patients were recruited and underwent MPCT colon with gas insufflation and antispasmodics. Results were compared with a cohort of 134 patients undergoing standard protocol MPCT colon. The numbers of false-positives were compared, as was reader confidence. All trial patients were given a questionnaire documenting their experience. Results: The number of false-positives was 15% in the control group and 5% in the trial group; this difference was statistically significant, (p50.01). Reader confidence was increased in the trial group. Patient tolerance was good, with 95% saying they would have the test again. Conclusion: Use of gas insufflation and antispasmodics reduces the false-positives from 15% to 5% without adversely affecting patient tolerance.

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“…For these reasons magnesium citrate should also be used with caution in the elderly, and has been associated with age-related increases in serum sodium, potassium, and urea, along with an increased risk for hypermagnesemia, with its resulting cardiac and neurologic complications 24, 27 . In addition, elderly patients with cardiovascular disease may be predisposed to ischemic colitis, which is a reported rare complication of bisacodyl use 28 .…”

Section: Currently Available Bowel Preparationsmentioning

confidence: 99%

Optimal Bowel Cleansing for Colonoscopy in the Elderly Patient

Hovsepians

Gupta

2017

Drugs Aging

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Colonoscopy is an important diagnostic and screening tool for colorectal cancer detection and prevention, and adequate bowel preparation is critical for successful colonoscopy. Complications related to colonoscopy are increased in elderly patients, either directly or indirectly related to the procedure, and the risks and benefits of colonoscopy procedures need to be carefully considered in these patients. Recent studies have shown that the 4 liter polyethylene glycol with a split preparation is safe and effective for elderly patients, and is the preferred preparation for patients with medical comorbidites. Preparations containing sodium phosphate are generally not recommended for the elderly due to increased renal complications. In addition, a low residue diet may aid in tolerance and willingness to undergo the procedure compared with a clear liquid diet, with comparable bowel preparation adequacy. Risk factors for inadequate bowel preparations include poor adherence to split preparation instructions or volume of solution ingested, and certain patient related medications and comorbidities, such as diabetes, elevated body mass index, and antidepressant or narcotic use. Methods for achieving safe and adequate bowel preparations in the elderly include clear instructions, reminder calls, and case management for potential confounding patient related factors.

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Effects of oral sodium picosulphate Picolax® on urea and electrolytes

Abstract: In normal circumstances, use of Picolax oral bowel preparation results in a statistically, but not clinically, significant reduction in concentration of serum urea, sodium and potassium.

Cited by 11 publications

References 0 publications

Bowel Preparations for Colonoscopy: An RCT

Bowel Preparations for Colonoscopy: An RCT

Gas insufflation of minimal preparation CT of the colon reduces false-positives

Optimal Bowel Cleansing for Colonoscopy in the Elderly Patient

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