Related Experiment Video
Updated: Mar 11, 2026
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Phosphate tablets or polyethylene glycol for preparation to colonoscopy? A multicentre non-inferiority randomized
Stanislas Chaussade1, Christoph Schmöcker2, Pierre Toulemonde3
1Gastroenterology and Endoscopy Unit, Faculté de Médecine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, Sorbonne Paris Cité, Pavillon Achard, 27 rue du faubourg St Jacques, 75014, Paris, France. stanislas.chaussade@aphp.fr.
Insights
Sodium phosphate (NaP) tablets are as effective as polyethylene glycol (PEG) for colonoscopy bowel prep. NaP tablets significantly improve patient compliance and ease of use, making them a viable option.
Area of Science:
- Gastroenterology
- Endoscopy
- Pharmacology
Background:
- Adequate bowel preparation is essential for colonoscopy quality.
- Polyethylene glycol (PEG) bowel cleansing has limitations, with up to 10% of colons inadequately prepared.
Purpose of the Study:
- To compare the efficacy, acceptability, tolerance, and safety of sodium phosphate (NaP) tablets versus split-dose PEG for bowel cleansing.
- To determine if NaP tablets are non-inferior to PEG in colon cleansing.
Main Methods:
- A prospective, non-inferiority randomized trial involving 461 patients.
- Patients were randomized to receive either 32 NaP tablets or 4L of PEG.
- Colon cleansing efficacy was assessed by blind readers using the Boston Bowel Preparation Scale (BBPS).
Main Results:
- Both NaP and PEG achieved good bowel preparation in 86.4% and 89.0% of cases, respectively (p=0.42).
- NaP was non-inferior to PEG across all colon segments.
- Patient compliance was significantly higher with NaP (99.6%) compared to PEG (94.1%) (p<0.001).
- NaP regimen was considered 'easy' by more patients (54.8%) than PEG (29.0%) (p<0.001).
- No serious adverse events were reported, with similar incidence of adverse events between groups.
Conclusions:
- Sodium phosphate (NaP) tablets are as effective as PEG for colon cleansing.
- NaP tablets offer improved patient compliance and ease of administration.
- NaP tablets are a suitable option for bowel preparation in patients without contraindications.
Background:
Adequate bowel preparation is a crucial step in colonoscopy procedure and has been identified as the cornerstone of a quality colonoscopy. Polyethylene glycol (PEG) for bowel cleansing still had up to 10 % unprepared colon.
Aim:
We herein compare efficacy, acceptability, tolerance and safety of sodium phosphate (NaP) tablets and split-dose PEG for bowel cleansing.
Patients And Methods:
A prospective non-inferiority randomized trial was performed and registered on www.clinicaltrials.gov (NCT01840553). Patients were randomized to either 32 NaP tablets or 4 L of PEG. Blind readers assessed the efficacy of colon cleansing using the Boston Bowel Preparation Scale (BBPS).
Results:
A total of 461 patients were randomized in groups (NaP group: n = 231; PEG group: n = 230). Median age was 54 and 52 in NaP group and PEG group, respectively (p < 0.01). Patients experienced an overall compliance to the treatment in 99.6 and 94.1 % in the NaP group and in the PEG group, respectively (p < 0.001). The mean time of withdrawal was 15.1 ± 8.9 and 15.4 ± 9.5 min in the NaP group and in the PEG group, respectively (p = 0.95). The good quality of bowel preparation, defined as BBPS score ≥7, was obtained in 86.4 and 89.0 % of cases in the NaP group and in the PEG group, respectively (p = 0.42). In all segment (right colon, transverse colon and left colon and rectum), the NaP group was non-inferior to the PEG group. Bowel prep regimen was more frequently considered as "easy" by patients from the NaP group (54.8 % of patients) than patients from the PEG group (29.0 % of patients; p < 0.001). No serious adverse events were reported. No statistical differences were found between the NaP group and the PEG group concerning the incidence of an adverse event (338 vs. 322, respectively).
Conclusion:
While NaP tablets appeared as efficient as PEG in terms of colon cleansing prior to a colonoscopy, they significantly improved the overall compliance and eased product administration. At an era where bowel cleansing appears to be the cornerstone of a quality colonoscopy, NaP tablets in patients without contraindication might be considered as an option.
Related Concept Videos
01:21Drugs for Treatment of Constipation-Predominant IBS
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
01:23Lower GI Series: Barium Enema
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
01:20Drugs Affecting GI Tract Motility: Other Laxatives
Osmotic or saline laxatives, like magnesium hydroxide or milk of...
01:25Endoscopic Procedures II: Colonoscopy
01:17Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...