Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 14, 2009; 15(14): 1759-1763
Published online Apr 14, 2009. doi: 10.3748/wjg.15.1759
Addition of senna improves quality of colonoscopy preparation with magnesium citrate
Stergios Vradelis, Evangelos Kalaitzakis, Yalda Sharifi, Otto Buchel, Satish Keshav, Roger W Chapman, Barbara Braden
Stergios Vradelis, Evangelos Kalaitzakis, Yalda Sharifi, Otto Buchel, Satish Keshav, Roger W Chapman, Barbara Braden, Department of Gastroenterology, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
Evangelos Kalaitzakis, Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
Author contributions: Vradelis S and Kalaitzakis E contributed equally as first authors in data analysis and editing the manuscript; Braden B designed the study, performed the data collection and wrote the manuscript; Sharifi Y, Buchel O, Keshav S and Chapman RW were involved in editing the manuscript; Kalaitzakis E also provided financial support for publishing this work.
Correspondence to: Dr. Barbara Braden, Professor, Consultant Gastroenterologist, Gastroenterology Department, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom.
Telephone: +44-1865-227860
Fax: +44-1865-2274
Received: October 25, 2008
Revised: March 3, 2009
Accepted: March 10, 2009
Published online: April 14, 2009

AIM: To prospectively investigate the effectiveness and patient’s tolerance of two low-cost bowel cleansing preparation protocols based on magnesium citrate only or the combination of magnesium citrate and senna.

METHODS: A total of 342 patients who were referred for colonoscopy underwent a colon cleansing protocol with magnesium citrate alone (n = 160) or magnesium citrate and senna granules (n = 182). The colonoscopist rated the overall efficacy of colon cleansing using an established score on a 4-point scale. Patients were questioned before undergoing colonoscopy for side effects and symptoms during bowel preparation.

RESULTS: The percentage of procedures rescheduled because of insufficient colon cleansing was 7% in the magnesium citrate group and 4% in the magnesium citrate/senna group (P = 0.44). Adequate visualization of the colonic mucosa was rated superior under the citramag/senna regimen (P = 0.004). Both regimens were well tolerated, and did not significantly differ in the occurrence of nausea, bloating or headache. However, abdominal cramps were observed more often under the senna protocol (29.2%) compared to the magnesium citrate only protocol (9.9%, P < 0.0003).

CONCLUSION: The addition of senna to the bowel preparation protocol with magnesium citrate significantly improves the cleansing outcome.

Keywords: Colonoscopy, Bowel preparation, Senna, Magnesium citrate, Polyp