Colonoscopy Clinical Trial
Official title:
A Single Blind, Single Centre, Parallel Group, Randomized Controlled Trial Comparing PEG Solution (Laxabon®) 4L Versus Senna Glycoside (Pursennid® Ex-Lax) 36mg and PEG Solution (Laxabon®) 2L for Large Bowel Cleansing Prior to Colonoscopy
The trial compares Laxabon® 4L versus Pursennid® Ex-Lax 36mg and 2L Laxabon® for large bowel cleansing prior to colonoscopy allocating patients planned for colonoscopy to one of the two cleansing regimens.
Effective large bowel cleansing prior to colonoscopy is still not achieved in all cases that
undergo the procedure. The use of balanced electrolyte-polyethylene glycol (PEG) solution
have improved the cleansing results and shortened the time needed for preparing the bowel.
The problem with using PEG solution alone is the relatively large volume of the solution
that the patients need to drink. The recommendation is to drink the solution until diarrhea
fluid is clear and often 4 L or more is needed. Many patients refuse to drink the sufficient
volume needed to get a clean colon. The large volume load can be a risk to patients
suffering from renal and/or heart insufficiency.
Good results of bowel cleansing have also been reported with sodium phosphate solution or
tablets. The fluid volume needed to drink along with sodium phosphate is generally no
problem but this regimen causes electrolyte disturbances that usually are subclinical and of
no significance but in patients with renal or heart insufficiency the sodium phosphate is
contraindicated due to the risk of serious electrolyte disturbances.
Several combinations of stimulant laxatives with PEG solution have been tested before and
the actual combination has been compared in one randomized study(1). Low-volume PEG plus
sennosides preparation was better tolerated but it was not as effective as standard
large-volume PEG.
PEG solution (Laxabon®) 4L is used for large bowel cleansing in many centers in Sweden and
is the standard regimen used in our colonoscopy unit. In this study we compare this standard
regimen with senna glycoside (Pursennid® Ex-Lax) 36mg (tablets) taken orally in the night
before the colonoscopy and 2L Laxabon® solution orally starting to drink the solution four
hours prior to the colonoscopy.
The result of large bowel cleansing is evaluated during the colonoscopy according to two
separate validated scoring methods (Aronchick and Ottawa scores). Abdominal symptoms,
discomfort, subjective grading of how hard/easy it was to complete the cleansing program and
extra costs are evaluated with questionnaires.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment
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