Peutz-Jeghers Syndrome

Patient Reports

Into the Bowels

A Report by Stephanie Sugars

For my search on bowel preparations for colonoscopy, the most fruitful was to choose two subjects: colonoscopy and cathartics. Colonoscopy with bowel preparation was also good but listed twice as many titles, many of them irrelevant.

Here's what I could figure out. There are four main types of bowel preparations in use.

• PEG or PEG-ELS, polyethylene glycol or polyethylene glycol with electrolytes. These are commercially known as Colyte, GoLytely, Klean Prep, Norgine and Fordtran. The PEG preps are taken in 2-4 litre doses the night and morning before scopes. Several articles compare the efficacy of different dosages.
   
• NaP or Sodium Phospate preps, also known as Fleet phospha-soda or De Witt. The usual dosage is 2 x 45 ml. Visicol, the 40 pill preparation we've written about here is sodium phosphate based. Visicol is taken in two doses of 30 grams 12 hours apart. All require a clear liquid diet the day before the procedure. There are warnings for patients with renal (kidney) failure, heart disease and other sodium related problems.
   
• Senna, Senoside B, X-prep and laxans seem to be a laxative based prep that often require a 3 day eating restriction. Sometimes PEG is added to this preparation.
   
• Magnesium Citrate is another type of preparation. I couldn't find dosages or how it is taken, but do know that there were tablets at one time that were combined with enema.

Less frequently reported are pico-lax (sodium pico-sulfate), castor oil and three day fasts.

These seem to be the main bowel preparations for colonoscopy. The abstracts of the articles I read compared and contrasted different methods of preparation for both patient compliance/comfort and physician satisfaction. I am sending three article titles below about the topic. I encourage everyone interested to review the abstracts available on medline. This is clearly a hot topic among gastroenterologists who want to make scopes and cleanses better for both patients and themselves.

All medical professionals are encouraged to give feedback, especially if you have clinic recommendations that differ from what's been written already.

© 2002 by Stephanie Sugars, all rights reserved, used by permission. No part of this article may be reproduced in any form without written permission from the author.

Contact Stephanie Sugars at PJ4Steph@aol.com

Email
Update: 21.Jan.'04