A Prospective Study Comparing Oral Sodium Phosphate Solution to a Bowel Cleansing Preparation with Nutrition Food Package in Children

El‐Baba, Mohammad; Padilla, Mary; Houston, Carmela; Madani, Shailender; Lin, Chen‐Chou; Thomas, Ronald; Tolia, Vasundhara

doi:10.1097/01.mpg.0000189353.40419.31

Cited by 32 publications

(38 citation statements)

References 18 publications

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“…Th e bowel cleansing eff ectiveness of NaP was superior to PEG in 1 study ( 207 ) and similar in another study ( 208 ). In a randomized study comparing a prepackaged diet kit including magnesium citrate and bisacodyl laxatives with NaP, the 2 regimens had comparable tolerability, although the quality of cleansing was superior with the magnesium citrate regimen ( 210 ). Th e Israeli Society of Pediatric Gastroenterology and Nutrition reviewed the evidence of adverse events with oral NaP and recommended that NaP should not be used in children younger than 12 years of age, children with any type of kidney disease, children treated with medications that aff ect renal function, children with signifi cant comorbidities (eg, liver disease, hypertension, hypoparathyroidism, diabetes, and heart disease), children at high risk for dehydration or electrolyte imbalance, and children with ileus or suspected severe colitis ( 211 ).…”

Section: Pediatricsmentioning

confidence: 76%

Optimizing Adequacy of Bowel Cleansing for Colonoscopy: Recommendations From the US Multi-Society Task Force on Colorectal Cancer

Johnson

Barkun

Cohen

et al. 2014

American Journal of Gastroenterology

136

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The American Journal of GASTROENTEROLOGY PRACTICE GUIDELINESColorectal cancer (CRC) is the second leading cause of cancerrelated deaths in the United States ( 1 ). Colonoscopy can prevent CRC by the detection and removal of precancerous lesions. In addition to CRC screening and surveillance, colonoscopy is used widely for the diagnostic evaluation of symptoms and other positive CRC screening tests. Regardless of indication, the success of colonoscopy is linked closely to the adequacy of preprocedure bowel cleansing.Unfortunately, up to 20-25% of all colonoscopies are reported to have an inadequate bowel preparation ( 2,3 ). Th e reasons for this range from patient-related variables such as compliance with preparation instructions and a variety of medical conditions that make bowel cleansing more diffi cult to unit-specifi c factors (eg, extended wait times aft er scheduling of colonoscopy) ( 4 ). Adverse consequences of ineff ective bowel preparation include lower adenoma detection rates, longer procedural time, lower cecal intubation rates, increased electrocautery risk, and shorter intervals between examinations ( 3,5-7 ).Bowel preparation formulations intended for precolonoscopy cleansing are assessed based on their effi cacy, safety, and tolerability. Lack of specifi c organ toxicity is considered to be a prerequisite for bowel preparations. Between cleansing effi cacy and tolerability, however, the consequences of inadequate cleansing suggest that effi cacy should be a higher priority than tolerability. Consequently, the choice of a bowel cleansing regimen should be based on cleansing effi cacy fi rst and patient tolerability second. However, effi cacy and tolerability are closely interrelated. For example, a cleansing agent that is poorly tolerated and thus not fully ingested may not achieve an adequate cleansing.Th e goals of this consensus document are to provide expert, evidence-based recommendations for clinicians to optimize colonoscopy preparation quality and patient safety. Recommendations are provided using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) scoring system, which weighs the strength of the recommendation and the quality of the evidence ( 8 ). METHODS Search StrategyComputerized medical literature searches were conducted from January 1980 (fi rst year of approval of polyethylene glycol-electrolyte lavage solution [PEG-ELS]-based preparation by the Food and Drug Administration [FDA]) up to August 2013 using MEDLINE, PubMed EMBASE, Scopus, CENTRAL, and ISI Web of knowledge. We used a highly sensitive search strategy to identify reports of randomized controlled trials ( 9 ) with a combination of medical subject headings adapted to each database and text words related to colonoscopy and gastrointestinal agents, bowel preparation, generic name, and brand name. Th e complete search terms are available in Appendix A. Recursive searches and cross-referencing also were performed using a "similar articles" function; hand searches of articles were identifi ed aft er an i...

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Section: Pediatricsmentioning

confidence: 76%

Optimizing Adequacy of Bowel Cleansing for Colonoscopy: Recommendations From the US Multi-Society Task Force on Colorectal Cancer

Johnson

Barkun

Cohen

et al. 2014

American Journal of Gastroenterology

136

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show abstract

“…69 PEG-3350 without electrolytes was shown to be efficacious in more than 90% of pediatric patients when used over a 4-day period. 20 An NaP solution was found to be less effective when compared with magnesium citrate used with a low-residue diet in one study, 70 although equally effective and more acceptable when compared with the same medication in addition to an enema. 71 Various other regimens, including senna or magnesium citrate with enema 27 and bisacodyl with enema, 72,73 were found to be efficacious in open-label prospective trials.…”

Section: Outcomes Data and Comparative Studiesmentioning

confidence: 97%

Colonoscopy preparation

Mamula¹,

Adler²,

Conway³

et al. 2009

Gastrointestinal Endoscopy

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“…Indeed, nearly all of the reported adverse outcomes with Fleet products in children occurred following enema administration [8,9] and not because of orally administered NaP. In addition, several prospective trials in pediatric patients [5,10,11] have found that oral NaP is a safe preparation for colonoscopy in children. These studies included children as young as three years of age; however, the degree of hyperphosphatemia observed in children was greater than that reported in adults [5].…”

mentioning

confidence: 96%

Risks of oral sodium phosphate for pre-colonoscopy bowel preparation in children

Baron

2007

Surg Endosc

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A Prospective Study Comparing Oral Sodium Phosphate Solution to a Bowel Cleansing Preparation with Nutrition Food Package in Children

Abstract: Although both regimens were comparable in adequacy of colon visualization, preparation tolerance, side effects and compliance profile in this pilot study, the prepackaged diet kit with magnesium citrate/bisacodyl laxative resulted in superior colon cleansing.

Cited by 32 publications

References 18 publications

Optimizing Adequacy of Bowel Cleansing for Colonoscopy: Recommendations From the US Multi-Society Task Force on Colorectal Cancer

Optimizing Adequacy of Bowel Cleansing for Colonoscopy: Recommendations From the US Multi-Society Task Force on Colorectal Cancer

Colonoscopy preparation

Risks of oral sodium phosphate for pre-colonoscopy bowel preparation in children

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