Oral sodium phosphate versus sulfate-free polyethylene glycol electrolyte lavage solution in outpatient preparation for colonoscopy: a prospective comparison

A Consensus Document on Bowel Preparation Before Colonoscopy: Prepared by a Task Force From The American Society of Colon and Rectal Surgeons (ASCRS), The American Society for Gastrointestinal Endoscopy (ASGE), and The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

“…Serum electrolyte abnormalities and extracellular fluid volume is altered, initially by increasing fluid retention, and then causing significant losses of both fluid and electrolytes in the stool effluent. 39,101 The significant volume contraction and resultant dehydration seen in some patients using NaP preparations may be lessened by encouraging patients to drink fluids liberally during the days leading up to their procedure, especially during their preparation. 94 Although usually asymptomatic, hyperphosphatemia is seen in as many as 40 percent of healthy patients completing NaP preparations, and may be significant in patients with renal failure.…”

A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

“…The following adverse events are characteristic of both formulations. Serum electrolyte abnormalities and extracellular fluid volume is altered, initially by increasing fluid retention, and then causing significant losses of both fluid and electrolytes in the stool effluent [39,101]. The significant volume contraction and resultant dehydration seen in some patients using NaP preparations may be lessened by encouraging patients to drink fluids liberally during the days leading up to their procedure, especially during their preparation [94].…”

“…Although usually asymptomatic, hyperphosphatemia is seen in as many as 40 percent of healthy patients completing NaP preparations, and may be significant in patients with renal failure [58,102]. As many as 20 percent of patients using NaP preparations develop hypokalemia; in addition, NaP has been shown to cause elevated blood urea nitrogen levels, decreased exercise capacity, increased plasma osmolality, hypocalcemia [101,103], and significant hyponatremia and seizures [104]. These significant blood chemistry abnormalities are more profound in children; therefore, NaP should not be used in children with acute and chronic renal failure, congestive heart failure, ileus, and ascites.…”

Randomized Study Comparing Two Regimens of Oral Sodium Phosphates Solution Versus Low-Dose Polyethylene Glycol and Bisacodyl

“…Fleet Co., Lynchburg, VA) is marketed as an over-the-counter laxative in the USA and as a bowel preparation worldwide. Because of the relatively small volume required, NaP has been extensively utilized and shown to be an effective cathartic for bowel cleansing prior to colonoscopy, radiographic procedures, and surgery [13][14][15][16][17][18][19][20]. The most commonly used dosage is a split regimen of two 45-ml doses separated by 6-12 h (45/45 ml).…”

“…The most commonly used dosage is a split regimen of two 45-ml doses separated by 6-12 h (45/45 ml). However, while this regimen is generally better tolerated and more acceptable than 4 l of polyethylene glycol (PEG) lavage, nausea, vomiting, anal irritation, and serum electrolyte shifts associated with NaP do occur [13,[15][16][17][18][19]21].…”