Adequate cleansing is essential for a thorough and accurate examination of the bowel during colonoscopy. Suboptimal preparation can lead to missed diagnoses, increased costs, and safety issues. Favorable bowel preparations are efficacious, safe, and cause as little patient discomfort as possible by limiting fluid volume, intolerance, and inconvenience. Split-dose (2-day) regimens address these concerns and are associated with better cleansing and higher patient satisfaction than with single-dose regimens. Nurses can play a key role in communicating the benefits of various bowel preparation options, including split dosing, to patients.
A low-volume oral sulfate solution given as a split-dose regimen has been tested in randomized clinical trials and found to provide similar bowel cleaning to split-dose polyethylene glycol with electrolytes and ascorbic acid (PEG-EA). Superior cleaning was found when compared with single-dose polyethylene glycol with electrolytes (PEG-ELS), particularly in the cecum and ascending colon. With the exception of clinically insignificant changes in electrolytes, tolerability and safety were similar between patients taking oral sulfate solution and patients taking PEG-EA or PEG-ELS. Oral sulfate solution is a safe and effective low-volume bowel preparation for colonoscopy.
Jack Di Palma, MD, is Professor of Medicine, Director of Division of Gastroenterology, University of South Alabama College of Medicine, Mobile, Alabama.
Douglas Rex, MD, is Professor of Medicine, Director of Endoscopy, Division of Gastroenterology and Hepatology, Indiana University Hospital, Indianapolis, Indiana.
Correspondence to: Jack Di Palma, MD, Division of Gastroenterology, University of South Alabama College of Medicine, 5600 Girby Road, Mobile, AL 36693 (e-mail: email@example.com).
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Received July 01, 2011
Accepted July 31, 2011