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Related Experiment Videos

Prospective, randomized, endoscopic-blinded trial comparing precolonoscopy bowel cleansing methods

S M Cohen1, S D Wexner, S R Binderow

  • 1Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale 33309-1743.

Diseases of the Colon and Rectum
|July 1, 1994
PubMed
Summary
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A small-volume sodium phosphate preparation for colonoscopy was preferred by patients and more effective for bowel cleansing compared to larger volume polyethylene glycol solutions. However, hyperphosphatemia was noted, potentially limiting use in renal impairment.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Endoscopy

Background:

  • Patient tolerance of precolonoscopy bowel preparation is often poor with standard large-volume solutions.
  • Smaller volume preparations may improve patient compliance and tolerability.

Purpose of the Study:

  • To compare patient compliance, cleansing ability, and safety of three oral colonoscopy preparations: standard polyethylene glycol (PEG), sulfate-free PEG, and oral sodium phosphate (OSP).

Main Methods:

  • Prospective randomized trial of 450 patients assigned to standard 4L PEG, 4L sulfate-free PEG, or 90ml OSP.
  • Assessed patient weight, serum electrolytes, and osmolarity pre- and post-preparation.
  • Utilized questionnaires for side effects and satisfaction; endoscopists blinded to preparation scored cleansing quality.

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Main Results:

  • OSP demonstrated superior colonic cleansing (90% excellent/good vs. 70-73% for PEG solutions) and higher patient preference for repeat use (83% vs. 19-33%).
  • No significant differences in weight or most biochemical parameters, but asymptomatic hyperphosphatemia occurred with OSP (P < 0.01).
  • No significant differences in side effect frequency or intensity were observed across groups.

Conclusions:

  • Oral sodium phosphate (OSP) offers a well-tolerated, effective, and preferred alternative for colonoscopy bowel preparation.
  • OSP's efficacy and patient preference are significant advantages over large-volume PEG solutions.
  • Potential for hyperphosphatemia with OSP necessitates caution in patients with renal impairment.