title: Bowel Preparation for Colonoscopy with Sodium Phosphate Solution versus Polyethylene Glycol-Based Lavage: A Multicenter Trial.
abstract: BACKGROUND
  Adequate bowel preparation is essential for accurate colonoscopy. Both oral sodium phosphate (NaP) and polyethylene glycol-based lavage (PEG-ELS) are used predominantly as bowel cleansing modalities. NaP has gained popularity due to low drinking volume and lower costs. The purpose of this randomized multicenter observer blinded study was to compare three groups of cleansing (NaP, NaP + sennosides, PEG-ELS + sennosides) in reference to tolerability, acceptance, and cleanliness.
  
  
  METHODS
  355 outpatients between 18 and 75 years were randomized into three groups (A, B, C) receiving NaP = A, NaP, and sennosides = B or PEG-ELS and sennosides = C. Gastroenterologists performing colonoscopies were blinded to the type of preparation. All patients documented tolerance and adverse events. Vital signs, premedication, completeness, discomfort, and complications were recorded. A quality score (0-4) of cleanliness was generated.
  
  
  RESULTS
  The three groups were similar with regard to age, sex, BMI, indication for colonoscopy, and comorbidity. Drinking volumes (L) (A = 4.33 + 1.2, B = 4.56 + 1.18, C = 4.93 + 1.71) were in favor of NaP (P = .005). Discomfort from ingested fluid was recorded in A = 39.8% (versus C: P = .015), B = 46.6% (versus C: P = .147), and C = 54.6%. Differences in tolerability and acceptance between the three groups were statistically not significant. No differences in adverse events and the cleanliness effects occurred in the three groups (P = .113). The cleanliness quality scores 0-2 were calculated in A: 77.7%, B: 86.7%, and C: 85.2%.
  
  
  CONCLUSIONS
  These data fail to demonstrate significant differences in tolerability, acceptance, and preparation quality between the three types of bowel preparation for colonoscopy. Cleansing with NaP was not superior to PEG-ELS.
authors.affiliation: Department of Internal Medicine and Gastroenterology, Evangelic Hospital Kalk, Buchforststrasse 2, 51103 Koeln, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schanz
authors.forename: W
authors.initials: W
authors.lastname: Kruis
authors.forename: O
authors.initials: O
authors.lastname: Mickisch
authors.forename: B
authors.initials: B
authors.lastname: Küppers
authors.forename: P
authors.initials: P
authors.lastname: Berg
authors.forename: B
authors.initials: B
authors.lastname: Frick
authors.forename: G
authors.initials: G
authors.lastname: Heiland
authors.forename: D
authors.initials: D
authors.lastname: Hüppe
authors.forename: B
authors.initials: B
authors.lastname: Schenck
authors.forename: H
authors.initials: H
authors.lastname: Horstkotte
authors.forename: A
authors.initials: A
authors.lastname: Winkler