Randomized Controlled Trial
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World J Gastroenterol. Nov 14, 2014; 20(42): 15845-15851
Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15845
Randomized controlled trial of sodium phosphate tablets vs polyethylene glycol solution for colonoscopy bowel cleansing
Yoon Suk Jung, Chang Kyun Lee, Hyo Jong Kim, Chang Soo Eun, Dong Soo Han, Dong Il Park
Yoon Suk Jung, Dong Il Park, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, South Korea
Chang Kyun Lee, Hyo Jong Kim, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul 110-746, South Korea
Chang Soo Eun, Dong Soo Han, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul 110-746, South Korea
Author contributions: Jung YS, Lee CK, Kim HJ, Eun CS, Han DS and Park DI designed research and acquired data; Jung YS, Lee CK, Eun CS and Park DI performed research; Jung YS analyzed data and wrote the paper; Jung YS, Lee CK, Kim HJ, Eun CS, Han DS and Park DI revised the manuscript critically for important intellectual content and approved the version to be submitted.
Correspondence to: Dong Il Park, MD, PhD, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyung-Dong, Jongro-Ku, Seoul 110-746, South Korea. diksmc.park@samsung.com
Telephone: +82-2-20012059 Fax: +82-2-20012049
Received: December 15, 2013
Revised: February 22, 2014
Accepted: June 2, 2014
Published online: November 14, 2014
Processing time: 337 Days and 2.6 Hours
Abstract

AIM: To compare efficacy, patient compliance, acceptability, satisfaction, safety, and adenoma detection rate of sodium phosphate tablets (NaP, CLICOLONTM) to a standard 4 L polyethylene glycol (PEG) solution for bowel cleansing for adults undergoing colonoscopy.

METHODS: In this multicenter, randomized, prospective, investigator-blind study, the relatively young (19-60 years) healthy outpatients without comorbidity were randomly assigned to one of two arms. All colonoscopy were scheduled in the morning. The NaP group was asked to take 4 tablets, 5 times the evening before and 4 tablets, 3 times early on the morning of the colonoscopy. The PEG group was asked to ingest 2 L of solution the evening before and 2 L early in the morning of the procedure. Adequacy of bowel preparation was scored using the Boston bowel preparation scale.

RESULTS: No significant differences were observed between the NaP group (n = 158) and PEG group (n = 162) in bowel cleansing quality (adequate preparation 93.0% vs 92.6%, P = 0.877), patient compliance (P = 0.228), overall adverse events (63.3% vs 69.1%, P = 0.269), or adenoma detection rate (34.8% vs 35.2%, P = 0.944). Patient acceptability, satisfaction, and patient rating of taste were higher in the NaP group than in the PEG group (P < 0.001).

CONCLUSION: NaP tablets, compared with PEG solution, produced equivalent colon cleansing, did not cause more side effects, and had better patient acceptability and satisfaction in the relatively young (age < 60 years) healthy individuals without comorbidity. An oral tablet formulation could make bowel preparation less burdensome, resulting in greater patient participation in screening programs.

Keywords: Sodium phosphate tablets; Polyethylene glycol; Colonoscopy; Bowel preparation

Core tip: Sodium phosphate (NaP) tablets were equally efficacious as standard 4 L polyethylene glycol (PEG) solution for bowel cleansing for colonoscopy and did not results in greater side effects. Furthermore, patient acceptance and satisfaction of NaP tablets were superior to 4 L PEG solution. NaP tablets in this trial were safe, well-tolerated, and efficient for bowel preparation in the relatively young (age < 60 years) healthy individuals without comorbidity. A more acceptable oral tablet formation might provide a valuable alternative for individuals who are reluctant to undergo colonoscopy because of aversion to the currently available purgatives.