title: A randomized prospective trial comparing different regimens of oral sodium phosphate and polyethylene glycol-based lavage solution in the preparation of patients for colonoscopy.
abstract: BACKGROUND
  Regulatory agencies have warned clinicians regarding the risk of electrolyte abnormalities if more than two 45-mL bottles of oral sodium phosphate (NaP) solution are administered within a 24-hour period.
  
  
  OBJECTIVE
  To compare the efficacy, safety, and tolerability of different regimens of oral NaP and polyethylene glycol (PEG).
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Teaching hospital outpatient endoscopy clinic.
  
  
  METHODS
  Two hundred outpatients without comorbidities who underwent routine colonoscopy.
  
  
  METHODS
  Two bottles of NaP, 6, 12, or 24 hours apart; or 4 L PEG.
  
  
  METHODS
  Bowel preparation quality, patient tolerability, and electrolyte changes.
  
  
  RESULTS
  The 12- and 24-hour NaP achieved better cleansing than the 6-hour NaP or PEG. Only 8.5% and 8.3% of patients in the 24- and 12-hour NaP had poor preparations, respectively, compared with 15.6% and 23.4% in the 6-hour NaP and PEG, respectively. The poorer preparation scores with PEG were partly because of a greater amount of colonic fluid. There were no relevant electrolyte changes with PEG, whereas hypokalemia, hypocalcemia, or hyperphosphatemia developed in 5% to 57% of patients on NaP. All regimens were poorly tolerated by patients.
  
  
  CONCLUSIONS
  The study was likely underpowered to detect small group differences in electrolytes.
  
  
  CONCLUSIONS
  A 24- or 12-hour NaP bowel preparation strategy was more effective than NaP 6 hours apart or PEG. PEG use is associated with more residual colonic fluid but represents an alternative to NaP in some clinical situations.
authors.affiliation: Division of Gastroenterology, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
authors.forename: Alaa
authors.initials: A
authors.lastname: Rostom
authors.forename: Emilie
authors.initials: E
authors.lastname: Jolicoeur
authors.forename: Catherine
authors.initials: C
authors.lastname: Dubé
authors.forename: Sylvie
authors.initials: S
authors.lastname: Grégoire
authors.forename: Dilip
authors.initials: D
authors.lastname: Patel
authors.forename: Navaaz
authors.initials: N
authors.lastname: Saloojee
authors.forename: Catherine
authors.initials: C
authors.lastname: Lowe
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D003106:Colon; D003113:Colonoscopy; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017060:Patient Satisfaction; D010710:Phosphates / Q000008:administration & dosage* / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D007507:Therapeutic Irrigation
chemical_list: D010710:Phosphates; D011092:Polyethylene Glycols; C018279:sodium phosphate