A COMPARISON OF THE EFFECTIVENESS AND PATIENT TOLERANCE OF ORAL SODIUM-PHOSPHATE, CASTOR-OIL, AND STANDARD ELECTROLYTE LAVAGE FOR COLONOSCOPY OR SIGMOIDOSCOPY PREPARATION

One hundred thirteen patients were randomized to receive either oral s odium phosphate (Fleet Phospho-Soda), lemon-flavored castor oil (Purge ), or standard polyethylene glycol-based lavage solution (GoLYTELY) be fore elective colonoscopy. The study purpose was to confirm the effica cy of oral sodium phosphate and extend observations to include castor oil. Overall, patients reported that sodium phosphate and castor oil w ere easier to complete (p < 0.05). Scores for cleansing the entire col on as determined by endoscopists who were blinded to the cathartic age nt were highest in patients receiving sodium phosphate (p < 0.02). Sco res of left-colon cleansing for flexible sigmoidoscopy were equally hi gh for the three methods. Scores for taste and symptom side effects we re similar for each preparation. There were no recognized signs or sym ptoms of hypocalcemia in the sodium phosphate group. Because of the lo w cost of oral sodium phosphate combined with the lowest repeat endosc opy rate for inadequate cleansing, patient savings were projected to b e $5000 per 100 patients at this center. Oral sodium phosphate is a co st-effective colonoscopy preparation that is better tolerated and more effective than the polyethylene glycol-electrolyte lavage solution or castor oil.