PROSPECTIVE, RANDOMIZED TRIAL COMPARING A NEW SODIUM PHOSPHATE-BISACODYL REGIMEN WITH CONVENTIONAL PEG-ES LAVAGE FOR OUTPATIENT COLONOSCOPYPREPARATION

Background: Several recent trials have shown that colonoscopy preparat ion with sodium phosphate solution is as effective and at least as wel l tolerated as conventional PEG-ES lavage. These trials utilized two 1 .5-fluid oz doses, one given on the evening before colonoscopy and the other early the next morning. Methods: We devised a new sodium phosph ate regimen in which the entire dose was given on the evening before e xamination (1.5 fl oz at 4 PM, 1.5-fl oz at 7 PM and 10 mg of bisacody l at 10 PM) and performed a prospective, randomized trial that compare d it with conventional PEG-ES lavage in terms of quality of colon clea nsing, patient tolerance, and safety in an outpatient colonoscopy popu lation with normal renal function. Seventy-two patients received sodiu m phosphate-bisacodyl and 75 PEG-ES lavage. Results: The overall quali ty of colon cleansing and frequency of unsatisfactory preparations wer e similar with both methods. Patients found preparation with sodium ph osphate-bisacodyl to be easier than PEG-ES lavage (p = 0.005). No clin ically important adverse effects were seen with either method of prepa ration. The average cost of sodium phosphate-bisacodyl was $4.32 per p atient compared with $18.15 for PEG-ES lavage preparation. Conclusion: Preparation with sodium phosphate-bisacodyl, given on the evening bef ore colonoscopy, is a well-tolerated, efficacious, and cost-effective alternative to conventional PEG-ES lavage.