Oral sodium phosphate compared with water enemas combined with bisacodyl as bowel preparation for elective colonoscopy.
BACKGROUND
Colonoscopy with high diagnostic accuracy requires a high quality of bowel preparation using a method that is well accepted. The aim of this study was to compare oral intake of sodium phosphate solution (SP) with a conventional method of bowel preparation using Bisacodyl combined with repeated water enemas until the appearance of clear return fluid (BE) on bowel preparation and to compare patient compliance in a randomized-investigator blinded trial.


METHODS
During a 3-months period, 253 consecutive patients referred for elective colonoscopy in the outpatient clinic were evaluated. After application of the exclusion criteria, 201 patients fulfilled the criteria for the trial; 119 were randomized to SP and 82 to BE.


RESULTS
The endoscopist reported a significantly (P = 0.001) improved overall bowel preparation after SP compared with BE. Emptying was significantly better in all segments of the colon except the caecum. Colonoscopy was incomplete in 9 patients (7.6%) in the SP group and in 3 patients (3.7%) in the BE group, but this difference was not significant. The number of patients with colon pathology was similar in both groups. Only 10% in the SP group would have preferred another preparation had this been possible, compared with 89% in the BE group (P < 0.0001). Only the SP preparation emerged as a negative independent predictor of poor bowel preparation after multivariate logistic regression modelling.


CONCLUSIONS
Patient compliance and quality of bowel preparation were better after SP than after BE.
Rasmussen
M
M
Dept. of Surgery A, Odense University Hospital, Odense, Denmark. mo.rasmussen@dadlnet.dk
Bohlbro
K
K
Qvist
N
N
D000368:Aged; D001726:Bisacodyl; D002400:Cathartics; D003113:Colonoscopy / Q000379:methods*; D017558:Elective Surgical Procedures / Q000379:methods*; D004733:Enema; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010710:Phosphates / Q000008:administration & dosage*; D014867:Water
D002400:Cathartics; D010710:Phosphates; D014867:Water; D001726:Bisacodyl; C018279:sodium phosphate