Sodium Laxate Research Paper

Sodium picosulphate: An effective laxative as colorectal cleanser in colonoscopy preparation

Introduction

Colonoscopy is a powerful diagnostic tool against several conditions such as inflammatory bowel disease, colonic polyps, and colon cancers Bhandari P, Inadequate bowel cleansing is associated with numerous negative consequences.( Park JB) The important barriers for the failure of colonoscopy include patient refusal to undergo colonoscopy and inadequate bowel cleansing. In the both the cases, patients unwillingness or intolerance to the preparation are important causes for the failure (Love J) . Patients prefer regimen that has better taste, low side-effects, and having manageable fluid intake (Bhandari P)). Sodium picosulphate may be preferred

((Love J). sodium picosulphate in combination with magnesium citrate has synergistic effects. As mentioned earlier, sodium picosulphate has purgative actions, while magnesium citrate (osmotic laxative) reacts with water thereby retaining fluids in the colon. By these dual mechanisms sodiumpicoslphate/magnesium citrate exerts its bowel cleansing effects. Various clinical studies evaluated its efficacy in comparison with other bowel preparation agents:

• In a randomized, multicentre, assessor-blinded, prespecified non-inferiority, head to head study, bowel cleansing effects of sodium picosulphate/magnesium citrate were compared with that of 2L polyethylene glycol solution and two 5-mg bisacodyl tablets. The study concluded that sodium picosulphate/ magnesium citrate was non-inferior to 2L polyethylene glycol solution and 5-mg bisacodyl tablets in terms of bowel cleansing effects. (Katz PO,)

• Randomized, single-blind study demonstrated that sodium picosulphate/magnesium citrate was more effective as a bowel cleansing agent than 0.01 or 0.02 g plus a sodium

A total of 400 consecutive patients presenting for elective colonoscopy were enrolled in the study. Study participants were treated either with sodium picosulphate or sodium phosphate. There is no difference in visualization of the colon with the both agents (p = 0.06). Sodium picosulphate was better tasted and better tolerated compared to sodium phosphate. Patients receiving sodium picosulphate reported significantly less nausea (P < 0.001), vomiting (P < 0.004), dizziness (P < 0.01), abdominal pains (P = 0.0005), and thirst (P < 0.0001) compared to sodium phosphate. Authors of the study opined that sodium picosulphate has similar efficacy but well-tolerated, better taste compared to sodium phosphate. (Schmidt