Randomized Clinical Trial
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 16, 2014; 6(8): 379-384
Published online Aug 16, 2014. doi: 10.4253/wjge.v6.i8.379
Bowel preparation for colonoscopy using standard vs reduced doses of sodium phosphate: A single-blind randomized controlled study
Tatsuya Koshitani, Mayumi Kawada, Toshikazu Yoshikawa
Tatsuya Koshitani, Mayumi Kawada, Division of Gastroenterology, Yamato Kenshin Center, Kyoto 6048171, Japan
Toshikazu Yoshikawa, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 6028566, Japan
Author contributions: Koshitani T designed the study, collected and analyzed the data and wrote the paper; Kawada M assisted with the study; Yoshikawa T supervised the study.
Correspondence to: Tatsuya Koshitani, MD, PhD, Division of Gastroenterology, Yamato Kenshin Center, 577-2 Toraya-cho, Nakagyo-ku, Kyoto 6048171, Japan. tkoshitani@aol.com
Telephone: +81-75-2564141 Fax: +81-75-2564235
Received: May 4, 2014
Revised: June 18, 2014
Accepted: July 17, 2014
Published online: August 16, 2014
Abstract

AIM: To evaluate the efficacy of a colonoscopy preparation that utilizes a reduced dose of sodium phosphate (NaP) and an adjunct.

METHODS: Sixty-two patients requiring screening colonoscopies were studied. Each patient was randomly allocated to receive either 50 NaP tablets (50 g) or 30 NaP tablets (30 g) with 10 mL of 0.75% sodium picosulfate for bowel preparation. NaP was administered at a rate of five tablets (5 g) or three tablets (3 g) every 15 min with 200 mL of water, beginning five to six hours before colonoscopy. The sodium picosulfate was administered with 200 mL of water on the night before the procedure. Both groups were compared in term of the efficacies of colonic cleansing, the time required for completion of the bowel preparation, and acceptability of the preparation.

RESULTS: Sixty patients (n = 30 for each group) were analyzed. The cleansing efficacy tended to be higher in the 30 g NaP plus sodium picosulfate group as assessed by the mean total Ottawa scale score (50 g NaP 6.70 ± 1. 42 vs 30 g NaP plus sodium picosulfate 6.17 ± 1.18 P = 0.072). The mean time for bowel preparation tended to be shorter in the 30 g NaP plus sodium picosulfate group (50 g NaP 189.9 ± 64.0 min vs 30 g NaP plus sodium picosulfate 161.8 ± 57.6 min, P = 0.065). There were no significant differences between the two groups in the acceptability of the preparations (50 g NaP 83.3% vs 30 g NaP plus sodium picosulfate 86.7%, P = 0.500). There were no adverse events related to bowel preparation in either of the groups.

CONCLUSION: The colonoscopy preparation that utilized 30 g NaP with sodium picosulfate was comparable to that utilizing 50 g NaP. This novel bowel preparation might be useful before colonoscopy.

Keywords: Bowel preparation, Colonoscopy, Colonoscopy preparation, Sodium phosphate, Sodium picosulfate

Core tip: Oral sodium phosphate (NaP) is used for bowel preparation before colonoscopy. It is desirable to reduce the dose of NaP due to the potential adverse events associated with NaP. In this study, we evaluated the efficacy of a colonoscopy preparation that utilized a reduced dose of NaP and an adjunct. This study demonstrated that 30 g NaP in combination with sodium picosulfate can be useful for bowel preparation prior to colonoscopy in Japanese populations. This report is the first to evaluate the efficacy of a bowel preparation using the minimally effective dose of NaP and an adjunct.