Systematic review: adverse event reports for oral sodium phosphate and polyethylene glycol

Belsey, Jonathan; Epstein, Owen; Héresbach, D.

doi:10.1111/j.1365-2036.2008.03837.x

Cited by 96 publications

(88 citation statements)

References 78 publications

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“…These encompass solely cathartic bowel preparation with agents used traditionally to prepare bowel for colonoscopy such as polyethylene glycol or sodium phosphate [1,2]. Full cathartic bowel preparation is associated with significant side-effects, including diarrhoea, abdominal pain and disruption to activities of daily living [3,4], and in extreme cases even death [5]. Previous studies have shown that patients often regard such bowel preparation for bowel investigation as the most burdensome part of the process [6,7].…”

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confidence: 99%

Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability

Pollentine¹,

Mortimer²,

McCoubrie³

et al. 2012

The British Journal of Radiology

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Objective: To compare a 2 day bowel preparation regime of barium, iodine and a mild stimulant laxative with a 1 day iodine-only regime for CT colonography (CTC). Methods: 100 consecutive patients underwent CTC. The first 50 patients (Regime 1) ingested 1 bisacodyl tablet twice a day 3 days before CTC and 1 dose each of 50 ml of barium and 20 ml of iodinated contrast per day starting 2 days before CTC. The second 50 patients (Regime 2) ingested 3 doses of iodinated contrast over 24 h prior to CTC. Volumes of residual stool and fluid, and the effectiveness of stool and fluid tagging, were graded according to methods established by Taylor et al (Taylor S, Slaker A, Burling D, Tam E, Greenhalgh R, Gartner L, et al. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging. Eur Radiol 2008; 18: 32-42). A 3 day low-residue diet was taken by both cohorts. Questionnaires rating the side-effects and burden of the bowel preparation were compared to a control cohort of patients undergoing barium enema. Results: The proportion of colons producing none/scattered stool (score 1) was 90.3% with Regime 1 and 65.0% with Regime 2 (p,0.005). Any residual stool was significantly better tagged with Regime 1 (score 5), with 91.7% of Regime 1 exhibiting optimum tagging vs 71.3% of Regime 2 (p,0.05). No significant differences in side-effects between the bowel preparation regimes for CTC were elicited. Bowel preparation for barium enema was tolerated significantly worse than both of the CTC bowel preparation regimes. Conclusion: Regime 1, containing a 3 day preparation of a mild laxative, barium and iodine, produced a significantly better prepared colon, with no difference in patient acceptability.

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confidence: 99%

Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability

Pollentine¹,

Mortimer²,

McCoubrie³

et al. 2012

The British Journal of Radiology

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“…NaP is a saline laxative administered in two doses of 45 mL diluted in 250 mL water each. Due to its mechanism of action, safety precautions should be taken with patients with a history of or risk of developing renal dysfunction [13] . Many clinical studies have attempted to determine which of these preparations provides better results in terms of colon cleansing, adherence and safety.…”

Section: What Is the Best Agent For Bowel Preparation?mentioning

confidence: 99%

Achieving the best bowel preparation for colonoscopy

Parra‐Blanco¹,

Ruiz²,

Álvarez-Lobos³

et al. 2014

WJG

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Bowel preparation is a core issue in colonoscopy, as it is closely related to the quality of the procedure. Patients often find that bowel preparation is the most unpleasant part of the examination. It is widely accepted that the quality of cleansing must be excellent to facilitate detecting neoplastic lesions. In spite of its importance and potential implications, until recently, bowel preparation has not been the subject of much study. The most commonly used agents are high-volume polyethylene glycol (PEG) electrolyte solution and sodium phosphate. There has been some confusion, even in published meta-analyses, regarding which of the two agents provides better cleansing. It is clear now that both PEG and sodium phosphate are effective when administered with proper timing. Consequently, the timing of administration is recognized as one of the central factors to the quality of cleansing. The bowel preparation agent should be administered, at least in part, a few hours in advance of the colonoscopy. Several low volume agents are available, and either new or modified schedules with PEG that usually improve tolerance. Certain adjuvants can also be used to reduce the volume of PEG, or to improve the efficacy of other agents. Other factors apart from the choice of agent can improve the quality of bowel cleansing. For instance, the effect of diet before colonoscopy has not been completely clarified, but an exclusively liquid diet is probably not required, and a low-fiber diet may be preferable because it improves patient satisfaction and the quality of the procedure. Some patients, such as diabetics and persons with heart or kidney disease, require modified procedures and certain precautions. Bowel preparation for pediatric patients is also reviewed here. In such cases, PEG remains the most commonly used agent. As detecting neoplasia is not the main objective with these patients, less intensive preparation may suffice. Special considerations must be made for patients with inflammatory bowel disease, including safety and diagnostic issues, so that the most adequate agent is chosen. Identifying neoplasia is one of the main objectives of colonoscopy with these patients, and the target lesions are often almost invisible with white light endoscopy. Therefore excellent quality preparation is required to find these lesions and to apply advanced methods such as chromoendoscopy. Bowel preparation for patients with lower gastrointestinal bleeding represents a challenge, and the strategies available are also reviewed here. Core tip: Bowel preparation for colonoscopy is a central issue related to the quality of the procedure. There are different agents for bowel preparation that can be administered with different schedules. We review the most commonly used agents, as well as new agents and combinations. Moreover, certain considerations should be taken into account for special populations in order to improve safety, efficacy and tolerance. Regimens for bowel preparation in special situations are discussed, such as for pedi...

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“…In the 90's began to use the sodium phosphate solution (21,22). Sodium phosphate is a saline laxative, which has the advantage of small volume required (2 vials of 45 mL) to achieve a proper colon cleansing, be as effective as and better tolerated by patients than PEG solution (23).…”

Section: Osmotic Solutions Hyperosmolarmentioning

confidence: 99%

Preparation for colonoscopy: types of scales and cleaning products

Lorenzo-Zúñiga

Moreno-de-Vega

Boix

2012

Rev. esp. enferm. dig.

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Adequate bowel preparation is essential before a colonoscopy, allowing us to make a proper examination of the entire mucosa. The ideal method of colon cleansing should be fast, safe, and get a proper cleaning with minimal discomfort for the patient. Today we have a wide variety of colon cleansing products, information sometimes becomes confused. A good colon preparation depends partly on correct choice of the same, but also upon dietary restriction. Knowledge of all these products, with their advantages and limitations, we can make a better selection for each patient, and although the efficacy is comparable, is the experience of the browser, patient preferences, and the degree of compliance with the instructions preparation, which greatly influence the results.

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Systematic review: adverse event reports for oral sodium phosphate and polyethylene glycol

Abstract: SUMMARY BackgroundScreening colonoscopy exposes healthy patients to the risk of serious adverse events associated with bowel preparation. Randomized controlled trials are not an effective method for evaluating this risk.

Cited by 96 publications

References 78 publications

Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability

Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability

Achieving the best bowel preparation for colonoscopy

Preparation for colonoscopy: types of scales and cleaning products

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