Effects of sodium picosulfate: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major Research Findings

Sodium picosulfate is a commonly used stimulant laxative for the treatment of constipation and bowel preparation for colonoscopy. 21 highlights its effectiveness and safety, recommending it as a first-line laxative. 22 mentions it as a stimulant laxative, approved for short-term constipation treatment. 8 suggests it as a potential option for chronic constipation, though it requires more research. However, 23 warns of a potential for severe hyponatremia when used for colonoscopy preparation. Studies like 11 and 10 explore different dosage regimens (same-day vs. split-dose) for bowel preparation.

Research also indicates that sodium picosulfate combined with magnesium citrate is a popular choice for bowel preparation due to its effectiveness and tolerability. 11 explores this combination. 17 studies a split-dose regimen of this combination for colonoscopy preparation. 24 compares the efficacy of sodium picosulfate with magnesium citrate to a novel PEG-based preparation. 6 investigates predicting inadequate bowel preparation when using sodium picosulfate plus magnesium citrate.

Benefits and Risks

Benefit Summary

Sodium picosulfate is an effective laxative for treating constipation and preparing the bowel for colonoscopy. 21 , 22 , 8

Risk Summary

Sodium picosulfate can lead to severe hyponatremia, especially when used for bowel preparation before colonoscopy. 23

Comparison of Studies

Commonalities

All studies indicate sodium picosulfate is an effective laxative for constipation and bowel preparation. 21 , 22 , 8 , 11 , 10 , 17 , 24 , 6

Differences

While most studies focus on sodium picosulfate's effectiveness, 23 highlights its potential for severe hyponatremia. 11 and 10 explore different dosage regimens, while 17 investigates the split-dose regimen with magnesium citrate.

Consistency and Contradictions

The research presents a mixed picture regarding sodium picosulfate. While its efficacy as a laxative is consistent, the potential for severe hyponatremia, especially during colonoscopy preparation, raises concerns. 21 , 22 , 8 , 23

Real-Life Applications and Cautions

Sodium picosulfate can be a helpful treatment for constipation, but it's essential to use it under a doctor's supervision. 23 emphasizes caution during colonoscopy preparation due to the risk of hyponatremia. 21 suggests individual preference plays a role in choosing laxatives.

Current Research Limitations

More research is needed to fully understand the risks and benefits of sodium picosulfate. 23 highlights the need for more research on its potential side effects. 8 emphasizes the need for rigorous studies to support the use of sodium picosulfate for chronic constipation.

Future Research Directions

Future research should focus on understanding the potential risks of sodium picosulfate, particularly hyponatremia. 23 and 8 suggest avenues for further research. Large-scale clinical trials are needed to assess the long-term effects and safety of sodium picosulfate in various populations. 22 emphasizes the need for evidence on long-term use.

Conclusion

Sodium picosulfate is a potentially effective laxative for constipation and bowel preparation. However, it's important to be aware of its potential side effects, particularly hyponatremia. 23 , 21 , 22 , 8 Consult your doctor before using sodium picosulfate to ensure it's safe and appropriate for you. More research is needed to fully understand its long-term effects and safety.

Literature analysis of 24 papers
Positive Content
22
Neutral Content
0
Negative Content
2
Article Type
9
2
3
2
20
2.

American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation.

Author: ChangLin, CheyWilliam D, ImdadAamer, AlmarioChristopher V, BharuchaAdil E, DiemSusan, GreerKatarina B, HansonBrian, HarrisLucinda A, KoCynthia, MuradM Hassan, PatelAmit, ShahEric D, LemboAnthony J, SultanShahnaz

CIC treatment

This clinical practice guideline provides evidence-based practice recommendations for the pharmacological treatment of chronic idiopathic constipation (CIC) in adults.

Practice GuidelineGuidelines and recommendations for the diagnosis and treatment of specific medical conditions in medical practice.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation.

Author: ChangLin, CheyWilliam D, ImdadAamer, AlmarioChristopher V, BharuchaAdil E, DiemSusan, GreerKatarina B, HansonBrian, HarrisLucinda A, KoCynthia, MuradM Hassan, PatelAmit, ShahEric D, LemboAnthony J, SultanShahnaz

CIC treatment

Chronic idiopathic constipation (CIC) is a common condition. This clinical practice guideline provides evidence-based recommendations for the pharmacological treatment of CIC in adults.

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

Language : English

4.

Cleaning effect and tolerance of 16 bowel preparation regimens on adult patients before colonoscopy: a network meta-analysis.

Author: SunMing, YangGuangzhao, WangYu

CRC diagnosis

This study compares different bowel preparation (BP) regimens for colonoscopy. It evaluates the cleaning effects and patient tolerance of several BP regimens using a network meta-analysis.

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

Language : English

5.

Randomized clinical trial evaluating three low-volume preparations for colonoscopy in outpatients with Inflammatory Bowel Disease: the EII-PREP trial.

Author: Rueda GarcíaJose Luis, Suárez FerrerCristina, Martín-ArranzEduardo, García-RamírezLaura, Sánchez-AzofraMaría, Poza CordónJoaquín, NociJesús, VergésTamara, Blanco San MiguelPaula, Martín-ArranzMaría Dolores,

Low-volume bowel preparations for colonoscopy in patients with inflammatory bowel disease showed no significant differences in efficacy between polyethylene glycol-ascorbate and sodium picosulfate. Sodium picosulfate was better tolerated and accepted by patients.

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

Language : English

7.

[Hyponatremic Seizure after Ingestion of an Oral Sulfate Tablet for Bowel Preparation for Colonoscopy].

Author: HongSung Hyun, LeeDong Seok, KimJi Won, LeeKook Lae, KangHyoun Woo, KimSu Hwan

OST hyponatremia
Seizure risk

Oral sulfate tablets (OST) are a bowel cleansing agent used to prepare patients for colonoscopies. A case report described an 81-year-old woman who developed hyponatremic seizure after taking OST for bowel preparation. This suggests that OST can cause hyponatremia and other complications.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : Korean

8.

Evidence-based treatment recommendations for OTC management of chronic constipation.

Author: RaoSatish S C, BrennerDarren M

Constipation relief
Abdominal pain
Diarrhea

Polyethylene glycol-based preparations and senna are recommended as first-line laxatives for chronic constipation based on good evidence from clinical trials.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

Comparative study between manitol and sodium picosulfate with magnesium oxide solutions in the preparation for colonoscopy.

Author: VissociCarolina Martins, SantosGustavo Travaglia, DuarteRoberta Paiva, PinheiroCristiano Guimarães DO Amaral, SilvaFernando Marinho Marques DA, PiresVitor Paiva, RochaJoão Lucas Farias DO Nascimento, CoelhoCassio Silva, OliveiraMaria Eduarda Rottili Gomes DE

Colonoscopy preparation
Side effects
Sleep impairment
Vomiting

This randomized, double-blind study compares two bowel preparation protocols for colonoscopy: one using Mannitol and the other using sodium picosulfate with magnesium oxide. Both protocols demonstrated good colon preparation efficiency, but the study found significant differences in side effects, with Mannitol associated with more vomiting and sleep impairment, while sodium picosulfate with magnesium oxide was considered easier to ingest.

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

10.

Split-dose low-volume polyethylene glycol is non-inferior but less preferred compared with same-day bowel preparation for afternoon colonoscopy.

Author: TajikaMasahiro, TanakaTsutomu, IshiharaMakoto, HirayamaYutaka, OnishiSachiyo, MizunoNobumasa, KuwaharaTakamichi, OkunoNozomi, MatsumotoShinpei, ToriyamaKazuhiro, ObataMasahiro, KuritaYusuke, KondoShinya, HaraKazuo, BhatiaVikram, AndoMasahiko, NiwaYasumasa

Bowel preparation

While a split-dose regimen for colonoscopy preparation is non-inferior to a same-day regimen, patients prefer the same-day regimen for its convenience.

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

11.

Comparison Between Same-Day and Split-Dose Preparations with Sodium Picosulfate/Magnesium Citrate: A Randomized Noninferiority Study.

Author: YangChen-Ta, HuangHsuan-Yuan, YenHsu-Heng, YangChia-Wei, ChenYang-Yuan, HuangSiou-Ping

Bowel cleansing
SPMC

This study aims to determine the optimal preparation of sodium picosulfate/magnesium citrate (SPMC) for bowel cleansing prior to afternoon colonoscopy. While SPMC is known to be effective and well-tolerated, there is limited data on the relative efficacy of same-day versus split-dose regimens for afternoon procedures.

Equivalence TrialA clinical trial designed to show that a new treatment is equivalent in efficacy/safety to an existing treatment.
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

12.

Effects of a Personalized Smartphone App on Bowel Preparation Quality: Randomized Controlled Trial.

Author: van der ZanderQuirine E W, ReumkensAnkie, van de ValkBas, WinkensBjorn, MascleeAd A M, de RidderRogier J J

bowel preparation
colonoscopy

Inadequate bowel preparation remains a significant problem in colonoscopy, leading to a higher risk of missing lesions, procedural difficulties, and increased healthcare costs.

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.

Efficacy of elobixibat as bowel preparation agent for colonoscopy: Prospective, randomized, multi-center study.

Author: YamaguchiDaisuke, HidakaHidenori, MatsunagaTakuya, AkutagawaTakashi, TanakaYuichiro, JubashiAmane, TakeuchiYuki, TsuruokaNanae, SakataYasuhisa, MiyaharaKoichi, TominagaNaoyuki, KawakuboHiroharu, TakamoriAyako, ShimodaRyo, NodaTakahiro, OgataShinichi, TsunadaSeiji, EsakiMotohiro

Colonoscopy bowel prep

A study compared the efficacy, tolerability, and safety of elobixibat, a novel ileal bile acid transporter inhibitor, and sodium picosulfate for bowel preparation for colonoscopy.

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

15.

Comparison of Four Bowel Cleansing Agents for Colonoscopy and the Factors Affecting their Efficacy. A Prospective, Randomized Study.

Author: KmochovaKlara, GregaTomas, NgoOndrej, VojtechovaGabriela, MajekOndrej, UrbanekPetr, ZavoralMiroslav, SuchanekStepan

Bowel cleansing
Colonoscopy quality
Adenoma detection
Side effects

Four different bowel cleansing agents were compared for efficacy in colonoscopy preparation. All agents achieved adequate bowel preparation, with no significant differences in polyp detection rates. MCSP was found to be the best-tolerated solution.

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

16.

Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review.

Author: RaoSatish S C, BrennerDarren M

constipation treatment
OTC therapies
adverse events

Polyethylene glycol (PEG) and senna are recommended as first-line laxatives for chronic constipation, based on good evidence. Fiber supplements, fruits, stimulant laxatives, and magnesium-based products are also supported by moderate evidence. More research is needed on other OTC constipation treatments.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

17.

Efficacy, tolerability and safety of a split-dose bowel cleansing regimen of magnesium citrate with sodium picosulfate - a phase IV clinical observational study.

Author: BorRenáta, MatuzMária, FabiánAnna, SzepesZoltán, SzántóKata, FarkasKlaudia, RutkaMariann, MilassinÁgnes, PigniczkiDaniella, BálintAnita, TóthTibor, MolnárTamás

Effective cleansing
Safe
Well tolerated
Electrolyte changes
Renal function changes

This phase IV observational study evaluated the efficacy, tolerability, and safety of magnesium citrate plus sodium picosulfate in colonoscopy preparation. The study found that this combination is highly effective and well-tolerated, with adequate and excellent bowel cleansing achieved in 94.85% and 72.96% of cases, respectively. While the combination caused significant changes in serum electrolytes and renal function, these changes were not clinically relevant.

Clinical Trial, Phase IVPost-marketing surveillance. Monitors long-term safety/efficacy after approval.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

19.

Pediatric bowel preparation: Sodium picosulfate, magnesium oxide, citric acid <i>vs</i> polyethylene glycol, a randomized trial.

Author: CuffariCarmen, CicioraSteven L, AndoMasakazu, BoulesMena, CroffieJoseph M

Effective bowel preparation
Safe bowel preparation

Sodium picosulfate, magnesium oxide, and citric acid (SPMC) was found to be an effective and safe bowel preparation for children 9-16 years undergoing elective colonoscopy, with comparable efficacy to polyethylene glycol (PEG). Tolerability was higher for SPMC compared to PEG.

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.
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

20.

Efficacy of drugs in chronic idiopathic constipation: a systematic review and network meta-analysis.

Author: LuthraPavit, CamilleriMichael, BurrNicholas E, QuigleyEamonn M M, BlackChristopher J, FordAlexander C

Constipation treatment efficacy

This network meta-analysis compared the efficacy of different drugs used to treat chronic idiopathic constipation.

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.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

22.

Long term treatment with stimulant laxatives - clinical evidence for effectiveness and safety?

Author: NoergaardMia, Traerup AndersenJon, Jimenez-SolemEspen, Bring ChristensenMikkel

Carcinogenic risk
Long-term colonic effects

This study reviewed the clinical trial evidence on the effectiveness and safety of long-term treatment with stimulant laxatives, bisacodyl and sodium picosulfate. The review found limited evidence to support the long-term use of these laxatives, highlighting concerns about harmful long-term colonic effects and potential carcinogenic risk.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Severe hyponatremia secondary to preparation for colonoscopy with sodium picosulfate/magnesium citrate.

Author: Azcune EcheverriaOlatz

Early colon cancer detection
Electrolyte imbalances

This case report describes a patient who experienced electrolytic imbalances after colonoscopy preparation.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
LetterA written message for communication and exchange of information between individuals.

Language : English

24.

Colon cleansing efficacy and safety with 1 L NER1006 versus sodium picosulfate with magnesium citrate: a randomized phase 3 trial.

Author: SchreiberStefan, BaumgartDaniel C, DrenthJoost P H, FilipRafał S, ClaytonLucy B, HylandsKerry, RepiciAlessandro, HassanCesare,

Effective bowel prep
Good colon cleansing
Safe and tolerable
Not applicable

The novel polyethylene glycol (PEG)-based preparation NER1006 was non-inferior to sodium picosulfate plus magnesium citrate for overall colon cleansing success and superior for high-quality cleansing of the right colon.

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.
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.
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

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