Prospective, randomized trial comparing a new sodium phosphate-bisacodyl regimen with conventional PEG-ES lavage for outpatient colonoscopy preparation.
BACKGROUND
Several recent trials have shown that colonoscopy preparation with sodium phosphate solution is as effective and at least as well tolerated as conventional PEG-ES lavage. These trials utilized two 1.5-fluid oz doses, one given on the evening before colonoscopy and the other early the next morning.


METHODS
We devised a new sodium phosphate regimen in which the entire dose was given on the evening before examination (1.5 fl oz at 4 PM, 1.5-fl oz at 7 PM  and 10 mg of bisacodyl at 10 PM) and performed a prospective, randomized trial that compared it with conventional PEG-ES lavage in terms of quality of colon cleansing, patient tolerance, and safety in an outpatient colonoscopy population with normal renal function. Seventy-two patients received sodium phosphate-bisacodyl and 75 PEG-ES lavage.


RESULTS
The overall quality of colon cleansing and frequency of unsatisfactory preparations were similar with both methods. Patients found preparation with sodium phosphate-bisacodyl to be easier than PEG-ES lavage (p = 0.005). No clinically important adverse effects were seen with either method of preparation. The average cost of sodium phosphate-bisacodyl was $4.32 per patient compared with $18.15 for PEG-ES lavage preparation.


CONCLUSIONS
Preparation with sodium phosphate-bisacodyl, given on the evening before colonoscopy, is a well-tolerated, efficacious, and cost-effective alternative to conventional PEG-ES lavage.
Afridi
S A
SA
Division of Gastroenterology, University of Missouri, School of Medicine, Columbia 65212, USA.
Barthel
J S
JS
King
P D
PD
Pineda
J J
JJ
Marshall
J B
JB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001726:Bisacodyl / Q000008:administration & dosage*; D003113:Colonoscopy / Q000379:methods*; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D004361:Drug Tolerance; D004573:Electrolytes / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000008:administration & dosage*; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011446:Prospective Studies; D007507:Therapeutic Irrigation / Q000379:methods*
D004573:Electrolytes; D010710:Phosphates; D001726:Bisacodyl; D011092:Polyethylene Glycols; C018279:sodium phosphate