Colonoscopy preparation

Pretreatment with a stimulant laxative before PEG-ELS does not affect serum electrolytes or hemodynamics

J. Schaberg, V. K. Sharma, S. Chockalingam, R. Vasudeva, Colin Howden

Research output: Contribution to journalArticle

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Abstract

We have previously shown that magnesium citrate or bisacodyl (Dulcolax™) given prior to polyethylene glycol electrolyte lavage solution (PEG-ELS) improves the quality of preparation for colonoscopy and is preferred by patients 11, 2). However, preparation with a stimulant laxative might result in undesirable changes in hemodynamics or serum electrolytes. Purpose: The aim of the present study was to examine the effects of either of these laxatives given with PEG-ELS on serum electrolytes, heart rate and blood pressure before and after preparation for colonoscopy. Methods: 42 consecutive outpatients undergoing colonoscopy were randomized to receive one of three preparations. Group 1 (n=16; mean age=63) received 4 liters of PEG-ELS. Group 2 (n=13; mean age=63) received 2 liters of PEG-ELS with 20 mg bisacodyl. Group 3 (n=13; mean age=64) received 2 liters of PEG-ELS preceded by 296 ml of magnesium citrate (1 bottle) given an hour prior. All patients had measurement of heart rate (HR), blood pressure (BP), serum sodium (Na), potassium (K), chloride (Cl), calcium (Ca), magnesium (Mg), phosphate (PO4), creatinine (Cr) and blood urea nitrogen (BUN) before preparation and immediately before colonoscopy. Values were compared using analysis of variance. Results: There were no significant changes in HR, BP or serum Na, K, Cl, Ca, PO4, Cr, or BUN. Mean serum Mg fell by 0.012 and 0.15 mEq/l in groups 1 and 2 respectively, and rose by 0.077 mEq/l in group 3 (P=0.023). Conclusions: There are statistically significant changes in serum Mg levels following preparation for colonoscopy with PEG-ELS and a stimulant laxative. These are minor and probably of no clinical relevance. They are of similar magnitude to a (previously unreported) change that occurs with PEG-ELS alone. Two liters of PEG-ELS with a stimulant laxative is a safe and effective means of preparation for colonoscopy.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume47
Issue number4
StatePublished - Dec 1 1998
Externally publishedYes

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Laxatives
Therapeutic Irrigation
Colonoscopy
Electrolytes
Hemodynamics
Serum
Bisacodyl
Heart Rate
Blood Urea Nitrogen
Blood Pressure
Magnesium
Creatinine
Calcium Chloride
Potassium Chloride
Analysis of Variance
Outpatients
Sodium

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Colonoscopy preparation : Pretreatment with a stimulant laxative before PEG-ELS does not affect serum electrolytes or hemodynamics. / Schaberg, J.; Sharma, V. K.; Chockalingam, S.; Vasudeva, R.; Howden, Colin.

In: Gastrointestinal Endoscopy, Vol. 47, No. 4, 01.12.1998.

Research output: Contribution to journalArticle

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abstract = "We have previously shown that magnesium citrate or bisacodyl (Dulcolax™) given prior to polyethylene glycol electrolyte lavage solution (PEG-ELS) improves the quality of preparation for colonoscopy and is preferred by patients 11, 2). However, preparation with a stimulant laxative might result in undesirable changes in hemodynamics or serum electrolytes. Purpose: The aim of the present study was to examine the effects of either of these laxatives given with PEG-ELS on serum electrolytes, heart rate and blood pressure before and after preparation for colonoscopy. Methods: 42 consecutive outpatients undergoing colonoscopy were randomized to receive one of three preparations. Group 1 (n=16; mean age=63) received 4 liters of PEG-ELS. Group 2 (n=13; mean age=63) received 2 liters of PEG-ELS with 20 mg bisacodyl. Group 3 (n=13; mean age=64) received 2 liters of PEG-ELS preceded by 296 ml of magnesium citrate (1 bottle) given an hour prior. All patients had measurement of heart rate (HR), blood pressure (BP), serum sodium (Na), potassium (K), chloride (Cl), calcium (Ca), magnesium (Mg), phosphate (PO4), creatinine (Cr) and blood urea nitrogen (BUN) before preparation and immediately before colonoscopy. Values were compared using analysis of variance. Results: There were no significant changes in HR, BP or serum Na, K, Cl, Ca, PO4, Cr, or BUN. Mean serum Mg fell by 0.012 and 0.15 mEq/l in groups 1 and 2 respectively, and rose by 0.077 mEq/l in group 3 (P=0.023). Conclusions: There are statistically significant changes in serum Mg levels following preparation for colonoscopy with PEG-ELS and a stimulant laxative. These are minor and probably of no clinical relevance. They are of similar magnitude to a (previously unreported) change that occurs with PEG-ELS alone. Two liters of PEG-ELS with a stimulant laxative is a safe and effective means of preparation for colonoscopy.",
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