Prospective, randomized, endoscopic-blinded trial comparing precolonoscopy bowel cleansing methods

Cohen, Stephen M.; Wexner, Steven D.; Binderow, Sander R.; Nogueras, Juan J.; Daniel, Norma; Ehrenpreis, Eli D.; Jensen, Jonathan B.; Bonner, Gregory F.; Ruderman, William B.

doi:10.1007/bf02054413

Cited by 262 publications

(169 citation statements)

References 28 publications

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“…A single patient reached a serum phosphorus level of 11.6 mg/dl (4). A larger study examined electrolyte changes in 143 patients who received OSPS and found a mean increase in serum phosphorus of 3 mg/dl and a mean decline in serum calcium of 0.3 mg/dl (5). A more recent study found that older patients achieve greater levels of hyperphosphatemia after use of OSPS (6).…”

Section: Discussionmentioning

confidence: 99%

Acute Phosphate Nephropathy following Oral Sodium Phosphate Bowel Purgative

Markowitz¹,

Stokes²,

D’Agati³

2005

Journal of the American Society of Nephrology

339

227

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Section: Discussionmentioning

confidence: 99%

Acute Phosphate Nephropathy following Oral Sodium Phosphate Bowel Purgative

Markowitz¹,

Stokes²,

D’Agati³

2005

Journal of the American Society of Nephrology

339

227

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“…Unfortunately, none of the preparations meets all of the requirements [2][3][4] . Several studies have evaluated the efficacy and side effects of regimens for bowel preparation [3][4][5][6][7][8][9][10][11][12][13][14] . In 2006, three medical organizations (the American Society for Gastrointestinal Endoscopy, the American Society of Colon and Rectal Surgeons, and the Society of American Gastrointestinal and Endoscopic Surgeons) suggested that polyethyleneglycol (PEG) should be a gold standard for colonoscopic bowel preparation (Grade IA), and aqueous sodium phosphate (NaP) was an alternative regimen to PEG solution (Grade IA) [2] .…”

Section: Introductionmentioning

confidence: 99%

Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation

Tongprasert

Sobhonslidsuk²,

Rattanasiri³

2009

WJG

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AIM:To evaluate the effectiveness of simethicone in enhancing visibility and efficacy during colonoscopy. METHODS:A prospective, double-blind, randomized, placebo-controlled study was conducted. One hundred and twenty-four patients were allocated to receive 2 doses of sodium phosphate plus 240 mg of tablet simethicone or placebo as bowel preparation. Visibility was blindly assessed for the amount of air bubbles and adequacy of colon preparation. Total colonoscopic time, side effects of the medication, endoscopist and patient satisfaction were also compared. RESULTS:Sodium phosphate plus simethicone, compared to sodium phosphate plus placebo, improved visibility by diminishing air bubbles (100.00% vs 42.37%, P < 0.0001) but simethicone failed to demonstrate improvement in adequacy of colon preparation (90.16% vs 81.36%, P = 0.17). Endoscopist and patient satisfaction were increased significantly in the simethicone group. However, there was no difference in the total duration of colonoscopy and side effects of the medication. CONCLUSION:The addition of simethicone is of benefit for colonoscopic bowel preparation by diminishing air bubbles, which results in enhanced visibility. Endoscopist and patient satisfaction is also increased.

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Severe Hyperphosphatemia and Hypocalcemia Caused by Bowel Preparation for Colonoscopy Using Oral Sodium Phosphate in End-Stage Renal Disease

Mishra

Kaufman²,

Mattern³

et al. 2006

Endoscopy

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Bowel preparations containing oral so− dium phosphate have gained increased favor among gastroenterology endosco− pists in preference to the traditional poly− ethylene glycol, likely due to greater pa− tient tolerability and improved cleansing and compliance [1]. Despite the availabil− ity of reports in the literature concerning life−threatening metabolic and cardiac abnormalities associated with the use of oral sodium phosphate in patients with renal insufficiency, less than half of re− spondents in a recent survey among gas− trointestinal endoscopists reported its ex− clusion in this patient population [2]. We report two cases of severe hyperphospha− temia and secondary hypocalcemia due to administration of an oral sodium phos− phate−containing bowel preparation in patients with chronic renal insufficiency.The first patient, a 51−year−old woman with end−stage renal disease requiring peritoneal dialysis, was evaluated for gen− eralized weakness, perioral tingling, elici− table Chvostek s sign, and a prolonged QT interval. The patient had ingested two 45− ml doses of Fleet s Phospho−Soda solution the previous night, in preparation for a screening colonoscopy. Laboratory evalu− ation revealed abnormal levels of calcium and phosphate in comparison with base− line values (Figure 1). Clinical symptoms and laboratory abnormalities of hypocal− cemic tetany resolved rapidly after the pa− tient received intravenous calcium and peritoneal dialysis. The patient subse− quently underwent colonoscopy without any complications and continued to be asymptomatic on follow−up.The second patient was a 57−year−old man with diabetes mellitus and chronic renal insufficiency who presented with hema− tochezia. Laboratory values on admission were unremarkable except for a serum creatinine of 2.1 mg/dl. At 2 days after in− gesting two doses of 45 ml of oral sodium phosphate for a colonoscopy, his metabol− ic profile demonstrated serum calcium and phosphate of 6.5 mg/dl and16.9 mg/ dl, respectively (Figure 1). He remained asymptomatic and received oral calcium acetate to bind phosphate. The patient was discharged in a stable condition with serum calcium and phosphate of 6.7 mg/ dl and 14.4 mg/dl, respectively. No fol− low−up information was available.Similar abnormalities in serum calcium and phosphate, associated with oral so− dium phosphate ingestion, have been re− ported in the absence of renal insufficien− cy. This may, however, be related to the dosage of oral sodium phosphate admi− nistered (greater than 90 ml) or to im− paired bowel motility leading to pro− longed intestinal transit time [3]. A 45− ml bottle of oral sodium phosphate con− tains approximately 6 g of inorganic phos− phate, while a person with normal renal function can handle an intake of phos− phate up to 4 g over a 24−hour period, due to reduced proximal tubular reab− sorption of phosphate [4]. A rise in serum phosphate is thought to be the primary etiology of hypocalcaemia in these pa− tients [5].Previously published literature does not report the magnitude of renal...

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Prospective, randomized, endoscopic-blinded trial comparing precolonoscopy bowel cleansing methods

Cited by 262 publications

References 28 publications

Acute Phosphate Nephropathy following Oral Sodium Phosphate Bowel Purgative

Acute Phosphate Nephropathy following Oral Sodium Phosphate Bowel Purgative

Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation

Severe Hyperphosphatemia and Hypocalcemia Caused by Bowel Preparation for Colonoscopy Using Oral Sodium Phosphate in End-Stage Renal Disease

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