Oral sodium phosphate compared with water enemas combined with Bisacodyl as bowel preparation for elective colonoscopy

Abstract

Background: Colonoscopy with high diagnostic accuracy requires a high quality of bowel preparation using a method that is well accepted. The aim of this study was to compare oral intake of sodium phosphate solution (SP) with a conventional method of bowel preparation using Bisacodyl combined with repeated water enemas until the appearance of clear return fluid (BE) on bowel preparation and to compare patient compliance in a randomized‐investigator blinded trial. Methods: During a 3‐months period, 253 consecutive patients referred for elective colonoscopy in the outpatient clinic were evaluated. After application of the exclusion criteria, 201 patients fulfilled the criteria for the trial; 119 were randomized to SP and 82 to BE. Results: The endoscopist reported a significantly (P = 0.001) improved overall bowel preparation after SP compared with BE. Emptying was significantly better in all segments of the colon except the caecum. Colonoscopy was incomplete in 9 patients (7.6%) in the SP group and in 3 patients (3.7%) in the BE group, but this difference was not significant. The number of patients with colon pathology was similar in both groups. Only 10% in the SP group would have preferred another preparation had this been possible, compared with 89% in the BE group (P < 0.0001). Only the SP preparation emerged as a negative independent predictor of poor bowel preparation after multivariate logistic regression modelling. Conclusion: Patient compliance and quality of bowel preparation were better after SP than after BE.

• Bisacodyl
• bowel preparation
• colonoscopy
• gut lavage
• sodium phosphate
• water enema