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OBJECTIVE: Comparison of three cleansing solutions for bowel preparation prior to colonoscopy. DESIGN: Prospective, randomized. METHOD: 140 outpatients referred for colonoscopy were randomized into three groups for cleansing with 4 litres PEG 4000, 4 litres PEG 3350 or with 90 ml sodium phosphate with an additional 2.5 litres of fluid. Between cleansing and colonoscopy, patients filled in a questionnaire concerning taste, abdominal cramps and tolerance to the procedure. Blinded to the type of cleansing the endoscopist scored the effects on the colon and rectosigmoid, and made the endoscopic diagnosis. RESULTS: All data were available for 127 of the 140 patients (50 men, 77 women), mean age 51 years (range 18-96). Comparison between the three groups showed no statistically significant difference in the opinion of the patients concerning taste, abdominal cramps and tolerance of lavage. The endoscopist's scoring of total colon cleansing showed a small reduction in colon cleanliness when using sodium phosphate compared to PEG 3350 (p = 0.03). No differences were found between the two PEG solutions. Combining both PEG solutions and comparing them with the sodium-phosphate solution showed fewer abdominal cramps (p = 0.07) with sodium phosphate and a cleaner colon with PEG (p = 0.07). Women complained slightly more of abdominal cramps and were slightly less tolerant of the procedure than men. Previous colonic surgery did not influence the results. Patients with diverticula were older, but no other effect of cleansing was found. CONCLUSION: The three preparations are comparable in their cleansing effect and tolerance by the patient.

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14974311&dopt=Abstract constipation laxative colon cleansing [PubMed - in process]

Dis Colon Rectum. 2004 Feb;47(2):238-42.
Picoprep-3 is a superior colonoscopy preparation to Fleet: a randomized, controlled trial comparing the two bowel preparations.

Schmidt LM, Williams P, King D, Perera D.

St George Hospital, Sydney, NSW, Australia.

PURPOSE: Bowel preparations for colonoscopy have to balance the demand for adequate cleansing action of the bowel and patient acceptability. There has been no study comparing Picoprep-3 (sodium picosulfate), a relatively new product, to Fleet (sodium phosphate), a well-studied and widely used preparation. This study was designed to compare the efficacy and patient tolerance of these two bowel preparations for colonoscopy. METHODS: A randomized, single-blinded, prospective trial was conducted. A total of 400 consecutive patients presenting for elective colonoscopy at St George Private Hospital during a 20-week period were randomly assigned to receive Picoprep-3 or Fleet. Patients were asked to record the effects of the preparation, noting tolerability, taste, and side effects. Two hundred patients were assigned to the Picoprep-3 group and 200 to the Fleet group. Surgeons were blinded to the preparation used and rated the quality of the bowel preparation on a scale of 1 to 5 (1 being the optimal score). RESULTS: Picoprep-3 was found to be better tolerated (P < 0.0001) and better tasting (P < 0.0001) than Fleet. Patients in the Picoprep-3 group reported significantly less nausea (P < 0.001), vomiting (P < 0.004), dizziness (P < 0.01), abdominal pains (P = 0.0005), and thirst (P < 0.0001) associated with the preparation. There was no significant difference in visualization of the colon between the two groups as judged by the two colonoscopists (P = 0.06). CONCLUSIONS: Colonoscopy preparation with Picoprep-3 has similar efficacy but superior taste and tolerability compared with Fleet. Picoprep-3 caused less adverse side effects in the study population.

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15043296&dopt=Abstract constipation laxative colon cleansing [PubMed - in process]

Am J Physiol. 1992 Jan;262(1 Pt 1):G62-8.
Effect of fluid perfusion and cleansing on canine colonic motor activity.

Sarna SK.

Department of Surgery, Medical College of Wisconsin, Milwaukee.

We investigated the effect of absorbable and nonabsorbable fluid perfusion and cleansing on colonic motor activity in eight intact conscious dogs. Each dog was instrumented with an indwelling catheter in the proximal colon and seven strain gauge transducers on the entire colon. After an overnight fast, a control recording was made for 3 h, followed by 3 h of perfusion and 3 additional h of postperfusion recording. Next day, a 3-h recording was made when the colon was empty. The colon exhibited normal migrating and nonmigrating motor complexes in the control uncleansed state. The perfusion of absorbable electrolyte or nonabsorbable Colyte solution immediately disrupted the migrating motor complexes and replaced them with almost continuous but irregular contractions at all recording sites. Both solutions significantly prolonged the mean and total duration per hour of contractile states in the proximal, middle, and distal colon. The dogs began to leak fluid stools in squirts approximately 40-80 min after the start of perfusion. This type of incontinence was not associated with any specific type of motor activity. Infrequently, giant migrating contractions occurred during perfusion and caused explosive diarrhea. The migrating motor complexes remained disrupted during the 3-h postperfusion period. However, on the next day, the empty colon exhibited normal migrating motor complexes. The frequency of giant migrating contractions during perfusion and in the empty colon was significantly greater than that in the normal uncleansed colon. The total duration per hour of colonic motor activity in the empty colon was also greater than that in the normal uncleansed colon. We conclude that excessive fluid in the colon significantly alters its motor pattern.(ABSTRACT TRUNCATED AT 250 WORDS)

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1733271&dopt=Abstract constipation laxative colon cleansing [PubMed - i

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