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[Colonic lavage prior to colonoscopy: comparable outcomes of two polyethylene-glycol preparations and a sodium-phosphate solution]

Author(s): Felt-Bersma RJ, Kooyman G, Kuipers EJ

Affiliation(s): Erasmus Medisch Centrum, afd. Maag-, Darm- en Leverziekten, Rotterdam. rjf.felt@vumc.nl

Publication date & source: 2004-01-24, Ned Tijdschr Geneeskd., 148(4):181-5.

Publication type: Clinical Trial; Randomized Controlled Trial

OBJECTIVE: Comparison of three cleansing solutions for bowel preparation prior to colonoscopy. DESIGN: Prospective, randomized. METHOD: 140 outpatients referred for colonoscopy were randomized into three groups for cleansing with 4 litres PEG 4000, 4 litres PEG 3350 or with 90 ml sodium phosphate with an additional 2.5 litres of fluid. Between cleansing and colonoscopy, patients filled in a questionnaire concerning taste, abdominal cramps and tolerance to the procedure. Blinded to the type of cleansing the endoscopist scored the effects on the colon and rectosigmoid, and made the endoscopic diagnosis. RESULTS: All data were available for 127 of the 140 patients (50 men, 77 women), mean age 51 years (range 18-96). Comparison between the three groups showed no statistically significant difference in the opinion of the patients concerning taste, abdominal cramps and tolerance of lavage. The endoscopist's scoring of total colon cleansing showed a small reduction in colon cleanliness when using sodium phosphate compared to PEG 3350 (p = 0.03). No differences were found between the two PEG solutions. Combining both PEG solutions and comparing them with the sodium-phosphate solution showed fewer abdominal cramps (p = 0.07) with sodium phosphate and a cleaner colon with PEG (p = 0.07). Women complained slightly more of abdominal cramps and were slightly less tolerant of the procedure than men. Previous colonic surgery did not influence the results. Patients with diverticula were older, but no other effect of cleansing was found. CONCLUSION: The three preparations are comparable in their cleansing effect and tolerance by the patient.

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