Comparing Bowel Cleansing Methods

ABSTRACT

BACKGROUND: Over the past several years, orthograde, peroral, and polyethylene glycol-electrolyte lavage (PEG-EL) has become the popular bowel cleansing agent before colonoscopic and surgical procedures on the colon and the rectum. Despite its proven efficacy, PEG-EL is difficult for some patients to tolerate. This has led to trials of a smaller-volume preparation (90 ml) using a sodium-phosphatebased laxative (NaP). There are reports of significant hyperphosphatemia following oral NaP and case reports of hypocalcemic tetany after NaP enemas. The purpose of this investigation was to assess 1) the changes in biochemical parameters and body weight, 2) the amount of residual stool, and 3) the side effects and patients satisfaction. METHODS: Sixty consecutive outpatients were prospectively randomized to undergo colonic cleansing with conventional PEG-LE or NaP. We analyzed the serum levels of sodium, potassium, magnesium, calcium, phosphate, BUN, albumin, and hematocrit at pre- and post-preparation. RESULTS: Serum sodium and phosphate levels increased significantly after NaP preparation. The changes of other elements were similar in both groups. The overall quality of colon cleansing and the frequency of satisfactory preparation were high in patients administered NaP. CONCLUSIONS: Preparation with NaP is a well-tolerated, efficacious alternative to conventional PEG-EL.