Cisapride does not improve precolonoscopy bowel preparation with either sodium phosphate or polyethylene glycol electrolyte lavage

Background. Oral sodium phosphate solution (NAP) and polyethylene glycol-el ectrolyte lavage (PEG-EL) are used for precolonoscopy bowel preparation. Th e benefit of adding cisapride to PEG-EL is controversial, and its influence on the effectiveness of NAP has not been investigated. The primary aim of this study was to determine whether cisapride improves the effectiveness an d/or tolerableness of bowel preparation with either NAP or PEG-EL. Methods: In 187 patients undergoing colonoscopy, a randomized, double-blind , placebo-controlled trial with a Latin square design was conducted to comp are 4 different bowel preparations: NAP plus either cisapride (10 mg; 2 dos es) or placebo, or PEG-EL plus either cisapride (10 mg; 1 dose) or placebo. Quality of the bowel preparation was graded by the endoscopist according t o the amount of stool present in the colon (excellent, satisfactory, unsati sfactory). To assess tolerability, patients rated 8 symptoms, the taste of the lavage solution, and the ease of preparation on a 5-point scale (1: eas y; 5: distressing). Results: Endoscopists scored the bowel preparation as either excellent or s atisfactory as follows: NAP: cisapride 50% versus placebo 61% (p = 0.3); PE G-EL: cisapride 80% versus placebo 78% (p = 1.0). Cisapride did not improve tolerability or the frequency of adverse symptoms associated with either s olution. The ease of bowel preparation was significantly better in the NAP group versus PEG-EL group (mean score 1.8 versus 2.8; p<0.0001). Conclusions: Cisapride does not improve the quality of bowel preparation wi th either NAP or PEG-EL. NAP is better tolerated by patients than PEG-EL; h owever, PEG-EL results in better bowel preparation.