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Colonoscopic bowel preparations--which one? A blinded, prospective, randomized trial
R W Golub1, B A Kerner, W E Wise
1Division of Colon and Rectal Surgery, Grant Medical Center, Columbus, Ohio, USA.
Diseases of the Colon and Rectum
|June 1, 1995
Summary
Oral sodium phosphate is a better bowel preparation for colonoscopy than polyethylene glycol-electrolyte lavage solutions (PEG-ELS). It is more tolerable, cost-effective, and leads to higher completion rates, improving patient compliance.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Endoscopy
Background:
- Polyethylene glycol-electrolyte lavage solutions (PEG-ELS) are standard bowel preparations for colonoscopy.
- Large volumes and poor palatability of PEG-ELS can cause side effects and reduce patient compliance.
Purpose of the Study:
- To compare patient acceptance, effectiveness, and safety of different colon-cleansing methods.
- To identify a preferred bowel preparation for colonoscopy.
Main Methods:
- Prospective randomized study of 329 patients undergoing colonoscopy.
- Three groups: PEG-ELS, PEG-ELS with metoclopramide, and oral sodium phosphate.
- Patients were matched for age and sex.
Main Results:
- Oral sodium phosphate was better tolerated and more likely to be completed (P < 0.001).
- No significant differences in nausea, vomiting, cramps, or irritation between groups.
- Sodium phosphate was four times less expensive than PEG-ELS.
Conclusions:
- All bowel preparation methods were equally effective for colonoscopy.
- Oral sodium phosphate offers superior tolerability, cost-effectiveness, and completion rates.
- Metoclopramide did not influence abdominal symptoms or preparation quality.