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Diagnostic and Therapeutic Endoscopy
Volume 2008, Article ID 713521, 6 pages
http://dx.doi.org/10.1155/2008/713521
Clinical Study

Bowel Preparation for Colonoscopy with Sodium Phosphate Solution versus Polyethylene Glycol-Based Lavage: A Multicenter Trial

1Department of Internal Medicine and Gastroenterology, Evangelic Hospital Kalk, Buchforststrasse 2, 51103 Koeln, Germany
2Gastroenterologische Gemeinschaftspraxis, O7, Nr 14 (Am Wasserturm), 68161 Mannheim, Germany
3Gastroenterologische Gemeinschaftspraxis, Dieburger Strasse 29, 64287 Darmstadt, Germany
4Gastroenterologische Gemeinschaftspraxis, Wiescherstrasse 20, 44623 Herne, Germany
5Gastroenterologische Gemeinschaftspraxis, Schmiedestrasse 18, 30159 Hannover, Germany

Received 30 October 2007; Revised 19 March 2008; Accepted 8 June 2008

Academic Editor: Guenter Janetschek

Copyright © 2008 S. Schanz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Adequate bowel preparation is essential for accurate colonoscopy. Both oral sodium phosphate (NaP) and polyethylene glycol-based lavage (PEG-ELS) are used predominantly as bowel cleansing modalities. NaP has gained popularity due to low drinking volume and lower costs. The purpose of this randomized multicenter observer blinded study was to compare three groups of cleansing (NaP, NaP + sennosides, PEG-ELS + sennosides) in reference to tolerability, acceptance, and cleanliness. Patient and Methods: 355 outpatients between 18 and 75 years were randomized into three groups (A, B, C) receiving NaP = A, NaP, and sennosides = B or PEG-ELS and sennosides = C. Gastroenterologists performing colonoscopies were blinded to the type of preparation. All patients documented tolerance and adverse events. Vital signs, premedication, completeness, discomfort, and complications were recorded. A quality score (0–4) of cleanliness was generated. Results: The three groups were similar with regard to age, sex, BMI, indication for colonoscopy, and comorbidity. Drinking volumes (L) (A = 4.33 + 1.2, B = 4.56 + 1.18, C = 4.93 + 1.71) were in favor of NaP ( = .005). Discomfort from ingested fluid was recorded in A = 39.8% (versus C: = .015), B = 46.6% (versus C: = .147), and C = 54.6%. Differences in tolerability and acceptance between the three groups were statistically not significant. No differences in adverse events and the cleanliness effects occurred in the three groups ( = .113). The cleanliness quality scores 0–2 were calculated in A: 77.7%, B: 86.7%, and C: 85.2%. Conclusions: These data fail to demonstrate significant differences in tolerability, acceptance, and preparation quality between the three types of bowel preparation for colonoscopy. Cleansing with NaP was not superior to PEG-ELS.