Side Effects of colon cleansing: A Synthesis of Findings from 21 Studies

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Original Abstract of the Article

Major Research Findings

Studies evaluating the efficacy and safety of sodium phosphate for colon cleansing have found that sodium phosphate is effective in cleaning the colon and is generally tolerated by patients. found that sodium phosphate was the most effective method for cleaning the entire colon and was better tolerated than polyethylene glycol (PEG) solutions or castor oil. 4 reported that sodium phosphate tablets were well tolerated and acceptable to patients compared to a 4L PEG solution. Evidence supporting the safe use of sodium phosphate is also reported in other studies. 19 showed that sodium phosphate caused fewer side effects and was better tolerated than PEG. 6 found that sodium phosphate tablets were well tolerated and acceptable to patients, and there was no difference in adenoma detection rates compared to PEG solutions.

Reasons for Side Effects

Sodium phosphate works by drawing water into the intestines, softening stools and promoting bowel movements. This action can lead to side effects such as diarrhea and abdominal pain. Sodium phosphate has also been suggested to disrupt the body's electrolyte balance. This can lead to side effects such as dehydration and hypocalcemia.

Common Side Effects

Diarrhea

The most common side effect of sodium phosphate is diarrhea. , 4 , 19 , 6 Numerous studies have reported diarrhea. Sodium phosphate works by drawing water into the intestines, softening stools and promoting bowel movements. This action can cause diarrhea.

Abdominal Pain

Another common side effect of sodium phosphate is abdominal pain. , 4 , 19 , 6 Numerous studies have reported abdominal pain. Sodium phosphate also promotes intestinal contractions. This action can cause abdominal pain.

Dehydration

Sodium phosphate can disrupt the body's electrolyte balance. This can lead to dehydration. reported that sodium phosphate is unlikely to cause dehydration, but it is important to be aware of the risk of dehydration.

Hypocalcemia

Sodium phosphate can decrease calcium levels in the body. This can lead to hypocalcemia. reported that sodium phosphate is unlikely to cause hypocalcemia, but it is important to be aware of the risk of hypocalcemia.

Side Effect Countermeasures

Diarrhea

If you experience severe diarrhea, it is important to stay hydrated. It may also be effective to take antidiarrheal medications.

Abdominal Pain

If you experience severe abdominal pain, it may be effective to take pain medication. Applying a warm towel to your abdomen can also be effective. If the abdominal pain does not improve, consult a doctor.

Dehydration

If you suspect dehydration, it is important to stay hydrated. It is also effective to drink electrolyte drinks.

Hypocalcemia

If you experience severe hypocalcemia, consult a doctor. You may need to take calcium supplements.

Comparison between Studies

Commonalities

Many studies have shown that sodium phosphate is effective in cleaning the colon. Most studies have also shown that sodium phosphate is generally tolerated by patients.

Differences

Comparison studies between sodium phosphate and PEG have shown that sodium phosphate is better tolerated than PEG, while other studies have shown that PEG has fewer side effects than sodium phosphate. 4 , 19 , 6 These findings suggest that it is necessary to consider the tolerance and risk of side effects for each patient when deciding whether sodium phosphate or PEG is better.

Precautions for Real-Life Applications

Sodium phosphate has been shown to be effective in cleaning the colon. 4 , 19 , 6 However, it can cause side effects such as dehydration and hypocalcemia. It is important to follow your doctor's instructions when using sodium phosphate. In particular, if you have an underlying medical condition such as kidney disease or heart disease, consult your doctor before using it.

Limitations of Current Research

There is not yet enough research on the long-term safety of sodium phosphate. There is also not enough data on how sodium phosphate affects pregnant and lactating women, the elderly, and children.

Future Research Directions

Further research on the long-term safety of sodium phosphate is needed. Research is also needed to investigate how sodium phosphate affects pregnant and lactating women, the elderly, and children.

Conclusion

Sodium phosphate has been shown to be effective in cleaning the colon. 4 , 19 , 6 However, it can also cause side effects such as dehydration and hypocalcemia. It is important to follow your doctor's instructions and understand the risks of side effects when using sodium phosphate.

Literature analysis of 21 papers
Positive Content
19
Neutral Content
1
Negative Content
1
Article Type
13
1
1
1
20
1.

Comparison of a new colon lavage solution (Golytely-RSS) with a standard preparation for air-contrast barium enema.

Author: TomlinsonT L, DiPalmaJ A, ManganoF A

Effective colon cleansing
May be preferable for renal/cardiovascular patients
Unpleasant side effects
Unwillingness to repeat

Golytely-RSS, a new formulation of Golytely, is an acceptable alternative to standard colon-cleansing methods for air-contrast barium enema. However, side effects were reported more frequently in the Golytely-RSS group.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Low-volume PEG plus ascorbic acid versus high-volume PEG as bowel preparation for colonoscopy.

Author: CorporaalSietske, KleibeukerJan H, KoornstraJan J

Improved tolerance
Reduced volume

Low-volume PEG + ascorbic acid has comparable efficacy and tolerability as high-volume PEG solution. The cleansing results were worse if patients received the full dose PEG + Asc the evening before the procedure compared to the split dose. Our data support the administration of PEG + Asc as a split dose before the procedure.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Efficacy and safety of sodium phosphate for colon cleansing in type 2 diabetes mellitus.

Author: OzturkNevin Akcaer, GokturkHuseyin Savas, DemirMehmet, UnlerGulhan Kanat, GurGurden, YilmazUgur

This study evaluated the efficacy, safety, and tolerability of sodium phosphate (NaP), and the quality of bowel cleansing in relation to glycemic control and late complications in diabetic patients.

Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Tolerability and patient acceptance of sodium phosphate tablets compared with 4-L PEG solution in colon cleansing: combined results of 2 identically designed, randomized, controlled, parallel group, multicenter phase 3 trials.

Author: KastenbergDavid, BarishCharles, BurackHarry, DalkeDouglas Dean, DuckorSteven, PutnamWilliam, ValenzuelaGregg,

Easy to take
Tolerable

Sodium phosphate tablets were more tolerable and acceptable than a 4-L polyethylene glycol solution for bowel preparation.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Lower Gastrointestinal Bleeding in the Emergency Department: High- Volume vs. Low-Volume Peg Bowel Preparation for Colonoscopy: A Randomized Trial.

Author: SavianoAngela, PetruzzielloCarmine, RiccioniMaria Elena, Di PumpoMarcello, PetrucciMartina, BrigidaMattia, ZanzaChristian, CandelliMarcello, FranceschiFrancesco, OjettiVeronica

Faster exam
Improved tolerability
Reduced administration time

Low-volume polyethylene glycol (PEG) solution (2L) may be a more tolerable and efficient option for colon cleansing before colonoscopy in patients with lower gastrointestinal bleeding compared to high-volume solutions (4L).

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.

Language : English

6.

Randomized controlled trial of sodium phosphate tablets vs polyethylene glycol solution for colonoscopy bowel cleansing.

Author: JungYoon Suk, LeeChang Kyun, KimHyo Jong, EunChang Soo, HanDong Soo, ParkDong Il

Equivalent colon cleansing
Improved patient acceptability
Improved patient satisfaction

Sodium phosphate tablets were found to be as effective as polyethylene glycol (PEG) solution in bowel cleansing for adults undergoing colonoscopy. Both treatments resulted in similar rates of adequate bowel preparation, patient compliance, overall adverse events, and adenoma detection rates. However, sodium phosphate tablets were associated with higher levels of patient acceptability, satisfaction, and taste preference.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Systematic review and meta-analysis of colon cleansing preparations in patients with inflammatory bowel disease.

Author: RestelliniSophie, KheradOmar, BessissowTalat, MénardCharles, MartelMyriam, Taheri TanjaniMaryam, LakatosPeter L, BarkunAlan N

Improved bowel cleansing
Side effects

Low-volume polyethylene glycol (PEG) regimens were as effective as high-volume PEG regimens in cleansing the colon of patients with inflammatory bowel disease. Low-volume regimens were also associated with greater willingness to repeat the procedure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Addition of senna improves quality of colonoscopy preparation with magnesium citrate.

Author: VradelisStergios, KalaitzakisEvangelos, SharifiYalda, BuchelOtto, KeshavSatish, ChapmanRoger W, BradenBarbara

Colon cleansing
Abdominal cramps

The addition of senna to the bowel preparation protocol with magnesium citrate significantly improves the cleansing outcome.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Comparison of reduced volume versus four liters sulfate-free electrolyte lavage solutions for colonoscopy colon cleansing.

Author: DiPalmaJack A, WolffBruce G, MeagherAlan, ClevelandMark vB

Improved patient tolerance

This study compared a reduced volume lavage regimen with standard 4 L SF-ELS lavage for safety and efficacy in colonoscopy preparation. The researchers found that the reduced volume regimen was as effective and well-tolerated as the standard 4 L regimen.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

11.

Mechanical colon cleansing for screening colonoscopy: A randomized controlled trial.

Author: AyubKamran, KetwarooGyanprakash, AbudayyehSuhaib, IbrahimAbeer, ColeRhonda A, Brumfield-BrownRosetta, QureshiWaqar A, RabeneckLinda, GrahamDavid Y

Improved colon preparation
Vomiting

This study compared pulsed irrigation evacuation (PIE), polyethylene glycol (PEG) and sodium phosphate colon preparations for colonoscopy. PIE and sodium phosphate were superior to PEG, with PIE being the preferred preparation for those at high risk of unsatisfactory preparations or with unsatisfactory traditional preparations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

12.

Magnesium citrate-bisacodyl regimen proves better than castor oil for colonoscopic preparation.

Author: ChenC C, NgW W, ChangF Y, LeeS D

Colon cleansing efficacy

This study compared colon cleansing efficacy, patient acceptance and side effects in patients given either a magnesium citrate-bisacodyl or a castor oil regimen prior to colonoscopy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

[Comparison of colon-cleansing methods in preparation for colonoscopy-comparative of solutions of mannitol and sodium picosulfate].

Author: de MouraDiogo Turiani, GuedesHugo, TortorettoVerônica, ArataqueTayrê Pádua, de MouraEduardo Guimarães, RománJuan Pablo, RodelaGustavo Luis, ArtifonEverson L

Bowel cleansing

Both mannitol and sodium picosulphate were safe and effective for bowel cleansing in preparation for colonoscopy, with patient acceptance and minimal complications. Mannitol was found to be slightly more effective, but no significant difference was observed between the two.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Spanish

15.

PillCam colon capsule endoscopy: a prospective, randomized trial comparing two regimens of preparation.

Author: SpadaCristiano, RiccioniMaria Elena, HassanCesare, PetruzzielloLucio, CesaroPaola, CostamagnaGuido

Improved colon cleansing
Reduced capsule excretion

Substituting sodium phosphate (NaP) with polyethylene glycol (PEG) boosters in the preparation protocol for PillCam Colon Capsule Endoscopy (CCE) resulted in a significantly reduced capsule excretion rate. While the PEG boosters partially compensated for the reduced excretion rate, further research is needed to optimize bowel preparation for CCE.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

A prospective study to assess the efficacy and patient tolerance of three bowel preparations for colonoscopy.

Author: RapierRoderick, HoustonCarmela

Improved colon cleansing
Patient tolerability

A low-residue diet kit combined with polyethylene glycol electrolyte or magnesium citrate and bisacodyl is effective and well-tolerated for bowel preparation before colonoscopy.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

17.

A randomized single-blind trial of whole versus split-dose polyethylene glycol-electrolyte solution for colonoscopy preparation.

Author: El SayedAmer M A, KanafaniZeina A, MouradFadi H, SoweidAssaad M, BaradaKassem A, AdorianClarisse S, NasreddineWalid A, ShararaAla I

Improved colonoscopy prep

This study evaluated the efficacy and tolerability of a split-dose polyethylene glycol-electrolyte solution plus bisacodyl and a regular diet for colonoscopy preparation. The regimen was found to be effective and well-tolerated.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

Polyethylene glycol 3350 based colon cleaning protocol: 2 d vs 4 d head to head comparison.

Author: ElitsurRotem, ButcherLisa, VickiLund, ElitsurYoram

Shorter preparation time
Higher stool frequency
No significant difference

A 2-day PEG 3350 protocol for colon cleansing was superior to a 4-day protocol for its shorter time, but no difference in adequacy was observed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Comparison of standard polyethylene glycol and two doses of oral sodium phosphate solution in precolonoscopy bowel preparation: a randomized controlled trial.

Author: PicchioM, GallinaroL, CeciF, GammardellaP, CalìB, RebonatoA, StagnittiF

Improved colon cleansing
Reduced side effects
Nausea

Two doses of sodium phosphate solution taken 24 h and 12 h before colonoscopy were more effective in colonic cleansing than standard 4-liters polyethylene glycol solution and had less side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

21.

Comparison of colon-cleansing methods in preparation for colonoscopy--comparative efficacy of solutions of mannitol, sodium picosulfate and monobasic and dibasic sodium phosphates.

Author: MikiPaulo, LemosCarlos Renato dos Reis, PopoutchiPedro, GarciaRicardo Luiz dos Santos, RochaJosé Joaquim Ribeiro da, FeresOmar

Good quality colon cleansing
No significant side effects
Blood pressure and pulse rate changes
Serum electrolytes altered

Sodium phosphate and 10% manitol solutions were equivalent in providing good quality colon cleansing, with no significant side effects that could compromise the procedure.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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