Korean J Gastroenterol.  2015 Jan;65(1):27-34. 10.4166/kjg.2015.65.1.27.

Randomized Controlled Trial of Sodium Phosphate Tablets versus 2 L Polyethylene Glycol Solution for Bowel Cleansing prior to Colonoscopy

• Lee YH
• Jeong SY
• Kim YS
• Jung HJ
• Kwon MJ
• Kwak CH
• Bae SI
• Moon JS
• Kim JW
• Kim SH
• Lee KL

• KMID: 2373177
• DOI: http://doi.org/10.4166/kjg.2015.65.1.27

Abstract

BACKGROUND/AIMS
Performance of polyethylene glycol solution (PEG) is often unsatisfactory as bowel preparation agent for colonoscopy. In order to provide equivalent efficacy with better patient tolerance, sodium phosphate tablet (SPT) has been developed. This study was carried out to compare the efficacy and compliance of two bowel preparation methods: PEG with ascorbic acid (PEGA) vs. SPT preparation.
METHODS
A multicenter, randomized controlled trial was performed. Primary efficacy variable was overall quality of colon cleansing assessed by Boston bowel preparation scale (BBPS) during colonoscopy. Patient's satisfaction and adverse events were evaluated by means of symptom questionnaire completed by each patient immediately before colonoscopy.
RESULTS
A total of 189 patients were randomly assigned to undergo pre-colonoscopic bowel preparation with either SPT (n=96) or PEGA (n=93). Overall BBPS score was 8.3+/-1.12 in the SPT group and 8.4+/-0.96 in the PEGA group (p=0.441). Among the 189 patients, 90 had polyps (47.6%) and 50 had adenomas (26.5%). The polyp/adenoma detection rate was 54.2% (n=52)/27.1% (n=26) for SPT group and 40.9% (n=38)/25.8% (n=24) for PEGA group (p=0.079 and 0.790, respectively). More number of patients were unable to take the prescribed dose of PEGA compared with the SPT regimen (8.6% vs. 2.0%, p=0.045). Overall satisfaction score was 7.9+/-1.63 in the SPT group and 7.4+/-1.53 in the PEGA group (p=0.022).
CONCLUSIONS
Degree of colon preparation, polyp/adenoma detection rate and adverse effect were similar between SPT group and PEGA group. Patient compliance and satisfaction were greater in the SPT group.

Keyword

Sodium phosphate; Polyethylene glycols; Bowel preparation solutions; Colonoscopy

MeSH Terms

Abdominal Pain/etiology
Adenoma/pathology
Adult
Ascorbic Acid/*therapeutic use
Cathartics/adverse effects/*therapeutic use
Colonic Polyps/pathology
*Colonoscopy
Female
Humans
Male
Middle Aged
Nausea/etiology
Patient Satisfaction
Phosphates/*therapeutic use
Polyethylene Glycols/*therapeutic use
Surveys and Questionnaires
Ascorbic Acid
Cathartics
Phosphates
Polyethylene Glycols

Figure

• 

  Fig. 1. Comparison of patient's satisfaction. (A) Patients preferred NaP tablet rather than PEGA. (B) There is no significant difference between groups for taste and quantity (p=0.864, p=0.488). ∗p=0.022. NaP, sodium phosphate; PEGA, polyethylene glycol with ascorbic acid.

• 

  Fig. 2. Detection rate of polyp and adenoma between the two groups. There is no significant difference between two groups in polyp detection rate (p=0.079) and adenoma detection rate (p=0.790). NaP, sodium phosphate; PEGA, polyethylene glycol with ascorbic acid.

Reference

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