Carbohydrate-electrolyte (E-Lyte) solution enhances bowel preparation with oral fleet phospho-soda.

Abstract

Bowel preparation with oral sodium phosphate can cause symptomatic dehydration and electrolyte disturbances. This randomized, controlled trial was designed to evaluate whether carbohydrate-electrolyte (E-Lyte) solution enhanced bowel preparation and improved patient acceptance with oral sodium phosphate. A total of 187 consecutive adults undergoing colonoscopy by two endoscopists were randomized to receive two packets of oral sodium phosphate (Fleet Phospho-soda) with or without additional supplement of a carbohydrate-electrolyte (E-Lyte) solution. All patients and endoscopists completed a standardized questionnaire. Urine-specific gravity and serum biochemistry were randomly performed in 150 and 50 patients, respectively. Ninety patients were randomized to have oral sodium phosphate with E-Lyte supplements (Group 1) and 94 patients to sodium phosphate without E-Lyte supplements (Group 2). The groups were similar in age and gender, indication for colonoscopy, and previous colonic surgery. Patients taking E-Lyte supplement had significantly less dizziness (none, 80 vs. 56 percent; P < 0.001) and a trend toward less nausea (none, 70 vs. 56 percent; P = 0.05). All patients in Group 1 completed the bowel preparation as opposed to 3 percent of Group 2 being unable to complete the preparation. Hypokalemia was significantly more frequent ( P = 0.008) in Group 2 patients without E-Lyte supplements. More patients in Group 2 needed intravenous rehydration (11 vs. 4 percent). Differences in serum creatinine and urine-specific gravity suggested possibly a lesser degree of hypovolemia in patients taking E-Lyte supplements. The quality of bowel cleansing in patients taking E-Lyte supplements was considered better by both the endoscopists and patients. Carbohydrate-electrolyte (E-Lyte) solution protects against hypokalemia, improves patient tolerability, and may enhance use of oral sodium phosphate as a bowel-preparation agent.