Colonoscopy Clinical Trial
Official title:
Prospective Randomized Comparison of Oral Sodium Phosphate and Sennoside A+B Calcium Lavage for Colonoscopy Preparation
The aim of the investigators study is to assess the bowel cleansing effects of two different agents and to compare their safety of application, ease of usage and effects on serum electrolytes.
Colorectal cancer is a leading cause of death from cancer. Because colonic cancer begins as
a small adenoma that , evolves into carcinoma over a decade or more pre-emptive colonoscopic
polypectomy can prevent this malignancy. For a good colonoscopic examination ideally the
colon should be cleansed of all fecal material because poor bowel preparation before
colonoscopy often leads to inability to reach the cecum or poor visualization of the mucosa
. Thus , pathology may be missed, repeat examinations may be scheduled at earlier intervals
than planned and the procedure is more difficult and time consuming. In addition , poor
bowel preparation can increase the risk of significant complications. Perforations resulting
from maneuvers has greater consequences in the setting of inadequate bowel preparation.
In the past two decades , various bowel preparation methods have been proposed including
castor oil, anthraquinones, phenolphtalein and magnesium citrate, in combination with low
residue diet4-7. Along these agents , cleansing enemas formed the traditional bowel
preparation. Oral sodium phosphate (Fleet Phospo-soda, C.B Fleet Co, Inc., Lynchburg,
Va.)(NaP) a preparation containing dibasic and monobasic sodium phosphate was proven to be
cost effective and has since been used worldwide8,9. NaP osmotically draws plasma water into
the bowel lumen to promote bowel cleansing. NaP must be accompanied by significant oral
fluid to prevent dehydration. Patients with compromised renal function, dehydration,
hypercalcemia or hypertension with the use of angiotensin converting enzyme inhibitors have
experienced phosphate nephropathy after use of oral NaP solutions.
Senna laxatives containing sennosides activated by colonic bacteria have a direct effect on
intestinal mucosa increasing the rate of colonic motility , enhancing colonic transit, and
inhibiting water and electrolyte secretion10. Sennosides may result in hypokalemia and
atonic colon.
The aim of our study is to assess the bowel cleansing effects of two different agents and to
compare their safety of application, ease of usage and effects on serum electrolytes.
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Observational Model: Case Control, Time Perspective: Prospective
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Completed |
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