BACKGROUND Research data from patient reports indicate that the least bearable part of colonoscopy is the administration of laxatives for bowel preparation.AIM To observe the intestinal cleansing efficacy and safety o...BACKGROUND Research data from patient reports indicate that the least bearable part of colonoscopy is the administration of laxatives for bowel preparation.AIM To observe the intestinal cleansing efficacy and safety of sodium picosulfate/magnesium citrate and to discuss the patients’experiences due to the procedure.METHODS Subjects hospitalized in the International Medical Center Ward of Peking University International Hospital,Beijing,China,from April 29 to October 29,2020,for whom the colonoscopy was planned,were enrolled.Bowel preparation was performed using sodium picosulfate/magnesium citrate.The effect of bowel cleansing was evaluated according to the Ottawa Bowel Preparation Scale,defecation conditions and adverse reactions were recorded,and the comfort level and subjective satisfaction concerning medication were evaluated by the visual analogue scale/score(VAS).RESULTS The bowel preparation procedure was planned for all patients enrolled,which included 42 males and 22 females.The results showed an average liquid rehydration volume of 3000 mL,an average onset of action for the first dose at 89.04 min,an average number of bowel movements of 4.3 following the first dose,an average onset of action for the second dose at 38.90 min and an average number of bowel movements of 5.0 after the second dose.The total average Ottawa Bowel Preparation Scale score was 3.6,with 93.55%of bowel preparations in the“qualified”and 67.74%in the“excellent”grade.The average VAS score of effect on sleep was 0,and the average VAS score of perianal pain was also 0.The average VAS score for ease of taking and taste perception of the bowel cleanser was 10.Side effects included mild to moderate nausea(15.63%),mild vomiting(4.69%),mild to moderate abdominal pain(7.81%),mild to moderate abdominal distension(20.31%),mild palpitation(7.81%)and mild dizziness(4.69%).CONCLUSION Sodium picosulfate/magnesium citrate is effective and safe for bowel preparation before colonoscopy with high subjective patient acceptance,thus improving overall patient compliance.展开更多
Oral purgatives such as sodium phosphate and sodium picosulfate/magnesium citrate (Picolax) combinations are commonly used as a preparation step for colonoscopies in Ireland. These substances can occasionally cause si...Oral purgatives such as sodium phosphate and sodium picosulfate/magnesium citrate (Picolax) combinations are commonly used as a preparation step for colonoscopies in Ireland. These substances can occasionally cause significant electrolyte disturbances including hyponatraemia. Although this is a rare complication of undergoing a colonoscopy, if not treated promptly and appropriately, these electrolyte abnormalities can be associated with life threatening complications. We report cases of symptomatic hyponatraemia in three women aged 65-75 years, following ingestion of Picolax in preparation for a colonoscopy. All three patients had documented previously normal electrolytes and all three required hospital admission for management of their electrolyte disturbance. However, the clinical presentations were variable and depended upon the severity of the hyponatraemia. Patient 1 presented with nausea and vomiting 7 hours post Picolax ingestion. Plasma sodium was 124 mmol/l. She was diagnosed with mild symptomatic hyponatraemia, and treated with anti-emetics and slow intravenous infusion of 0.9% Saline. Patient 2 developed acute confusion 8 hours following ingestion of Picolax. Plasma sodium was 120 mmol/l and she was clinically dehydrated. She was also treated with intravenous 0.9% Saline. Patient 3 presented with seizures and reduced GCS, 48 hours post Picolax ingestion. Plasma sodium was 111 mmol/l. As she had severe life threatening hyponatraemia with seizures, she was treated with boluses of 3% hypertonic saline. It is recommended that cleansing agents should be used with caution in the elderly, patients with a low seizure threshold, patients with renal impairment, liver cirrhosis, heart failure, and patients on diuretics. These patients should have plasma sodium monitored pre- and post-colonoscopy to ensure early detection of hyponatraemia if present, and to initiate prompt and appropriate management to prevent the serious complications associated with hyponatraemia.展开更多
AIM:To evaluate the efficacy and acceptability of magnesium citrate and a single dose of oral sodium phosphate(45 mL) solution for morning colonoscopy bowel preparation. METHODS:A total of 159 patients were randomly a...AIM:To evaluate the efficacy and acceptability of magnesium citrate and a single dose of oral sodium phosphate(45 mL) solution for morning colonoscopy bowel preparation. METHODS:A total of 159 patients were randomly assigned to receive two split doses of 90 mg of sodium phosphate(GroupⅠ,n=79) or magnesium citrate(250 mL,the day before the procedure) followed by 45 mL of sodium phosphate(the day of procedure,GroupⅡ,n= 80) .The quality of bowel cleansing and the acceptability of each regimen were compared,including the satisfaction,taste,willing to repeat and adverse effects of each regimen. RESULTS:The quality of bowel cleansing of GroupⅡ was as good as that of GroupⅠ(An Aronchick scale score of good or excellent:70.9%vs 81.0%,respectively,P=0.34;the Ottawa system score:4.4±2.6 vs 3.8 ±3.0,respectively,P=0.76) .There was no statisticallysignificant difference between both groups with regard to acceptability,including the satisfaction,taste and willingness to repeat the regimen.A significantly greater number of older patients(over 65 years old) in Group Ⅱgraded the overall satisfaction as satisfactory(48.1% vs 78.1%,respectively;GroupⅠvs GroupⅡ,P=0.01) . There were no significant adverse reactions. CONCLUSION:Magnesium citrate and a single dose of sodium phosphate was as effective and tolerable as the conventional sodium phosphate regimen and is a satisfactory option.展开更多
BACKGROUND Bowel preparation in children can be challenging.AIM To describe the efficacy, safety, and tolerability of sodium picosulfate, magnesium oxide, and citric acid(SPMC) bowel preparation in children.METHODS Ph...BACKGROUND Bowel preparation in children can be challenging.AIM To describe the efficacy, safety, and tolerability of sodium picosulfate, magnesium oxide, and citric acid(SPMC) bowel preparation in children.METHODS Phase 3, randomized, assessor-blinded, multicenter study of low-volume, divided dose SPMC enrolled children 9-16 years undergoing elective colonoscopy. Participants 9-12 years were randomized 1:1:1 to SPMC ? dose × 2, SPMC 1 dose × 2, or polyethylene glycol(PEG). Participants 13-16 years were randomized 1:1 to SPMC 1 dose × 2 or PEG. PEG-based bowel preparations were administered per local protocol. Primary efficacy endpoint for quality of bowel preparation was responders(rating of ‘excellent' or ‘good') by modified Aronchick Scale. Secondary efficacy endpoint was participant's tolerability and satisfaction from a 7-item questionnaire. Safety assessments included adverse events(AEs) and laboratory evaluations.RESULTS 78 participants were randomized, 48 were 9-12 years, 30 were 13-16 years. For the primary efficacy endpoint in 9-12 years, 50.0%, 87.5%, and 81.3% were responders for SPMC ? dose × 2, SPMC 1 dose × 2, and PEG groups, respectively. Responder rates for 13-16 years were 81.3% for SPMC 1 dose × 2 and 85.7% for PEG. Overall, 43.8% of participants receiving SPMC 1 dose × 2 reported it was ‘very easy' or ‘easy' to drink, compared with 20.0% receiving PEG. Treatment-emergent AEs were reported by 45.5% of participants receiving SPMC 1 dose × 2 and 63.0% receiving PEG.CONCLUSION SPMC was an efficacious and safe for bowel preparation in children 9-16 years, with comparable efficacy to PEG. Tolerability for SPMC was higher compared to PEG.展开更多
基金Beijing Science and Technology Program,China,Early Endoscopic Diagnosis for Colorectal Cancer—The Guidance Study,No.D17110002617002.
文摘BACKGROUND Research data from patient reports indicate that the least bearable part of colonoscopy is the administration of laxatives for bowel preparation.AIM To observe the intestinal cleansing efficacy and safety of sodium picosulfate/magnesium citrate and to discuss the patients’experiences due to the procedure.METHODS Subjects hospitalized in the International Medical Center Ward of Peking University International Hospital,Beijing,China,from April 29 to October 29,2020,for whom the colonoscopy was planned,were enrolled.Bowel preparation was performed using sodium picosulfate/magnesium citrate.The effect of bowel cleansing was evaluated according to the Ottawa Bowel Preparation Scale,defecation conditions and adverse reactions were recorded,and the comfort level and subjective satisfaction concerning medication were evaluated by the visual analogue scale/score(VAS).RESULTS The bowel preparation procedure was planned for all patients enrolled,which included 42 males and 22 females.The results showed an average liquid rehydration volume of 3000 mL,an average onset of action for the first dose at 89.04 min,an average number of bowel movements of 4.3 following the first dose,an average onset of action for the second dose at 38.90 min and an average number of bowel movements of 5.0 after the second dose.The total average Ottawa Bowel Preparation Scale score was 3.6,with 93.55%of bowel preparations in the“qualified”and 67.74%in the“excellent”grade.The average VAS score of effect on sleep was 0,and the average VAS score of perianal pain was also 0.The average VAS score for ease of taking and taste perception of the bowel cleanser was 10.Side effects included mild to moderate nausea(15.63%),mild vomiting(4.69%),mild to moderate abdominal pain(7.81%),mild to moderate abdominal distension(20.31%),mild palpitation(7.81%)and mild dizziness(4.69%).CONCLUSION Sodium picosulfate/magnesium citrate is effective and safe for bowel preparation before colonoscopy with high subjective patient acceptance,thus improving overall patient compliance.
文摘Oral purgatives such as sodium phosphate and sodium picosulfate/magnesium citrate (Picolax) combinations are commonly used as a preparation step for colonoscopies in Ireland. These substances can occasionally cause significant electrolyte disturbances including hyponatraemia. Although this is a rare complication of undergoing a colonoscopy, if not treated promptly and appropriately, these electrolyte abnormalities can be associated with life threatening complications. We report cases of symptomatic hyponatraemia in three women aged 65-75 years, following ingestion of Picolax in preparation for a colonoscopy. All three patients had documented previously normal electrolytes and all three required hospital admission for management of their electrolyte disturbance. However, the clinical presentations were variable and depended upon the severity of the hyponatraemia. Patient 1 presented with nausea and vomiting 7 hours post Picolax ingestion. Plasma sodium was 124 mmol/l. She was diagnosed with mild symptomatic hyponatraemia, and treated with anti-emetics and slow intravenous infusion of 0.9% Saline. Patient 2 developed acute confusion 8 hours following ingestion of Picolax. Plasma sodium was 120 mmol/l and she was clinically dehydrated. She was also treated with intravenous 0.9% Saline. Patient 3 presented with seizures and reduced GCS, 48 hours post Picolax ingestion. Plasma sodium was 111 mmol/l. As she had severe life threatening hyponatraemia with seizures, she was treated with boluses of 3% hypertonic saline. It is recommended that cleansing agents should be used with caution in the elderly, patients with a low seizure threshold, patients with renal impairment, liver cirrhosis, heart failure, and patients on diuretics. These patients should have plasma sodium monitored pre- and post-colonoscopy to ensure early detection of hyponatraemia if present, and to initiate prompt and appropriate management to prevent the serious complications associated with hyponatraemia.
文摘AIM:To evaluate the efficacy and acceptability of magnesium citrate and a single dose of oral sodium phosphate(45 mL) solution for morning colonoscopy bowel preparation. METHODS:A total of 159 patients were randomly assigned to receive two split doses of 90 mg of sodium phosphate(GroupⅠ,n=79) or magnesium citrate(250 mL,the day before the procedure) followed by 45 mL of sodium phosphate(the day of procedure,GroupⅡ,n= 80) .The quality of bowel cleansing and the acceptability of each regimen were compared,including the satisfaction,taste,willing to repeat and adverse effects of each regimen. RESULTS:The quality of bowel cleansing of GroupⅡ was as good as that of GroupⅠ(An Aronchick scale score of good or excellent:70.9%vs 81.0%,respectively,P=0.34;the Ottawa system score:4.4±2.6 vs 3.8 ±3.0,respectively,P=0.76) .There was no statisticallysignificant difference between both groups with regard to acceptability,including the satisfaction,taste and willingness to repeat the regimen.A significantly greater number of older patients(over 65 years old) in Group Ⅱgraded the overall satisfaction as satisfactory(48.1% vs 78.1%,respectively;GroupⅠvs GroupⅡ,P=0.01) . There were no significant adverse reactions. CONCLUSION:Magnesium citrate and a single dose of sodium phosphate was as effective and tolerable as the conventional sodium phosphate regimen and is a satisfactory option.
文摘BACKGROUND Bowel preparation in children can be challenging.AIM To describe the efficacy, safety, and tolerability of sodium picosulfate, magnesium oxide, and citric acid(SPMC) bowel preparation in children.METHODS Phase 3, randomized, assessor-blinded, multicenter study of low-volume, divided dose SPMC enrolled children 9-16 years undergoing elective colonoscopy. Participants 9-12 years were randomized 1:1:1 to SPMC ? dose × 2, SPMC 1 dose × 2, or polyethylene glycol(PEG). Participants 13-16 years were randomized 1:1 to SPMC 1 dose × 2 or PEG. PEG-based bowel preparations were administered per local protocol. Primary efficacy endpoint for quality of bowel preparation was responders(rating of ‘excellent' or ‘good') by modified Aronchick Scale. Secondary efficacy endpoint was participant's tolerability and satisfaction from a 7-item questionnaire. Safety assessments included adverse events(AEs) and laboratory evaluations.RESULTS 78 participants were randomized, 48 were 9-12 years, 30 were 13-16 years. For the primary efficacy endpoint in 9-12 years, 50.0%, 87.5%, and 81.3% were responders for SPMC ? dose × 2, SPMC 1 dose × 2, and PEG groups, respectively. Responder rates for 13-16 years were 81.3% for SPMC 1 dose × 2 and 85.7% for PEG. Overall, 43.8% of participants receiving SPMC 1 dose × 2 reported it was ‘very easy' or ‘easy' to drink, compared with 20.0% receiving PEG. Treatment-emergent AEs were reported by 45.5% of participants receiving SPMC 1 dose × 2 and 63.0% receiving PEG.CONCLUSION SPMC was an efficacious and safe for bowel preparation in children 9-16 years, with comparable efficacy to PEG. Tolerability for SPMC was higher compared to PEG.
