Colonoscopy Polyethylene glycol

Irrigation with large volumes of a polyethylene glycol-electrolyte solution, e.g. Klean-Prep, by mouth causes minimal fluid and electrolyte disturbance (it was developed for preparation for colonoscopy). Magnesium sulphate may also be used. 

Regev A, Fraser G, Delpre G, Leiser A, Neeman A, Maoz E, Anikin V, Niv Y. Comparison of two bowel preparations for colonoscopy sodium picosulphate with magnesium citrate versus sulphate-free polyethylene glycol lavage solution. Am J Gastroenterol 1998 93(9) 1478-82. 

Oral sodium phosphate 90 ml mixed with 300 ml of clear liquid has been compared with 2 liters of polyethylene glycol solution in a colonoscopist-blinded, randomized trial in 100 patients undergoing colonoscopy as a daycare procedure (40). Sodium phosphate was well tolerated and safe and provided bowel cleansing similar to polyethylene glycol. Five patients who received polyethylene glycol and four who received sodium phosphate reported nausea, and eight patients who received polyethylene glycol and one who received sodium phosphate complained of abdominal fullness. 

Reddy DN, Rao GV, Sriram PV. Efficacy and safety of oral sodium phosphate versus polyethylene glycol solution for bowel preparation for colonoscopy. Indian J Gastroenterol 2002 21(6) 219-21. 

VannerSJ, MacDonald PH, Paterson WG, Prentice RS, Da Cost LR, Beck iT. A randomized prospective trial comparing oral sodium phosphate with standard polyethylene glycol-based lavage solution (Golytely) in the preparation of patients for colonoscopy. Am J Gastroenterol 1990 85 422-7. 

Abaskharoun R, DepewW, Vanner S. Changes in renal function following administration of oral sodium phosphate or polyethylene glycol cleansing before colonoscopy. Can J Gastroenterol. 2007 21 227-231. 

Polyethylene glycol electrolyte solutions, such as GoLytely and Colyte, are used routinely as whole-bowel irrigants prior to colonoscopy and bowel surgery. These solutions also can be used as a means to decontaminate the gastrointestinal tract of ingested toxins. " Large volumes of these osmotically balanced solutions... 

Comparative studies Sodium phosphate versus polyethylene glycol In a randomized, open study of renal failure after administration of oral sodium phosphate solutions or solutions containing polyethylene glycol for bowel cleansing before colonic endoscopy, 93 patients with normal renal function were allocated to oral sodium phosphate (two 45-ml doses of Fleets Phos-phoSoda separated by 12 hours) or polyethylene glycol (4 liters of Colyte) combined with adequate hydration [85 ]. Renal function was assessed 1 week before, immediately before, and 1 week after colonoscopy. No subject had acute renal failure after either formulation. However, oral sodium phosphate was associated with significant rises in serum phosphate and... 

Turner D, Benchimol FI, Dunn H, Griffiths AM, Frost K, Scaini V, Avolio J, ling SC. Pico-Salax versus polyethylene glycol for bowel cleanout before colonoscopy in children a randomised controlled trial Endoscopy 2009 41(12) 1038-45. 

Alhara H, Saito S, Arakava H, Imazu H, Omar S, Raise M, Tajiri H. Comparison of two sodium phosphate tablet-based regimens and a polyethylene glycol regimen for colon cleansing prior to colonoscopy a randomized prospective pilot study. Int J Colorectal Dis 2009 24(9) 1023-30. 

Polyethylene glycol electrolyte lavage solution is often the agent preferred by gastroenterologists for colonic cleansing in patients prior to fiberoptic colonoscopy. One unit of the solution is composed of 236 g of polyethylene glycol as well as electrolytes such as sodium and potassium and is administered orally in a large volume to empty the colon. 

Magnesium citrate has been used with a reduced total volume of polyethylene glycol lavage solution prior to colonoscopy as a strategy to improve patient compliance and tolerance. This has also been found to improve the quality of colonic cleansing and to decrease preparation times (Sharma et al. 1998). 

Hookey LC, Depew WT, Vanner S (2002) The safety profile of oral sodium phosphate for colonic cleansing before colonoscopy in adults. Gastrointest Endosc 56 895-902 Hsu CW, Imperiale TF (1998) Meta-analysis and cost comparison of polyethylene glycol lavage versus sodium phosphate for colonoscopy preparation. Gastrointest Endosc 48 276-82... 

If necessary, same day optical colonoscopy can be performed by preparing the patients with some additional laxatives after CT colonography (for instance 1 or 2 L of polyethylene glycol. Optical colonoscopy can be performed some 2 h after starting this additional prep (Lefere et al. 2002). 

Mineral and metal metabolism Two women, aged 65 and 70 years, developed tonic-clonic seizmes after intake of polyethylene glycol solutions as bowel preparation for colonoscopy. In both cases, 4 L of polyethylene glycol solutions were taken. However, the addition of 3 L of clear water was taken by the second patient. Seizures were associated with elevated blood pressure and hyponatraemia. Both patients were treated with intravenous sodium solutions. The normalisation of sodium levels was followed by a complete neurologic recovery. Follow-up visits showed normal sodium levels without residual neurologic deficiencies [71 ]. 

Polyethylene glycol-electrolyte solution (PEG) is routinely prescribed for bowel cleansing, but often poorly tolerated by patients. Sodium phosphate (NaP) may be an alternative. Patients who previously xmderwent colonoscopy were invited to participate in the study and were randomly assigned to PEG or NaP. The endoscopist filled out a report about preparation, tolerability and future preferences. A total of 125 patients were included in the study, 7 of whom were excluded because of missing data. The remaining 116 (53 PEG and 63 NaP) patients were included in the analysis [51 ]. 

Van Vugt A, Van Pinxteren MWJ, Van Kouwen MCA, Van Oijen MGH, Van Achterberg T, Nagengast FM. A prospective study of bowel preparation for colonoscopy with polyethylene glycol-electrolyte solution versus sodium phosphate in Lynch syndrome a randomized trial. Fam Cancer 2012 11(3) 337-41. 

Fonchon T, Boustiere C, Hersbach D, Tarrerias AL, Halphen M. A low-volume polyethylene glycol plus ascorbate solution for bowel cleansing prior to colonoscopy The NORMO randomized clinical trial. Dig Liver Dis 2013 45(10) 820-6. 

Cesaro P, Hassen C, Spada C, Petruzziello L,Vitale G, Costamagna G. A new low-volume polyethylene glycol solution plus bisacodyl versus split-dose 4L polyethylene glycol for bowel clean-sing prior to colonoscopy a randomized control trial. Dig Liv Dis 2013 45(l) 23-7. 

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