Bowel Prep for Colonoscopy

Abstract

Purpose: To compare the efficacy and patient tolerance of an oral high dose of Senna suspension to a conventional sodium phosphate lavage in adults undergoing elective colonoscopy. Methods: Outpatients referred for elective colonoscopy were prospectively and randomly assigned to receive, the day before the procedure, either two doses of liquid Senna each comprised of 90ml (158.4mg equivalent) given at 1 pm and 9 pm (Senna group n = 50), or a standard Sodium Phosphate bowel prep (45 ml of NaP solution) two doses taken the day before the exam (NaP group n = 50). The primary outcome measure was the overall quality of colon cleansing utilizing the Aroncheck scoring scale (1 = excellent to 4 = poor/inadequate). Three investigators/endoscopists participated in the three month trial and all three were blinded to the type of prep assignment. Patient tolerance/compliance was assessed using a structural questionnaire: poor, fair, or good (Symptoms of intolerance, compliance).The data was analyzed using the Mann-Whitney U Test to compare the results of bowel cleansing and Patient tolerance/compliance. Results:Table: Tolerance.Table: Preparation Quality.Tolerance of the Senna preparation and compliance with it were significantly better than conventional Sodium Phosphate.Overall cleansing quality appears to be comparable or slightly better. Conclusions: Given the problems associated with currently available Colon cleansing regimens (Large volume and unpleasant taste of PEG-ES, recent safety concerns with Sodium Phosphate) an oral high dose of Senna is a valid, safe and well tolerated alternative for outpatient colonoscopy preparation. Larger prospective studies are needed.