Dr Franco Radaelli and colleagues assessed the efficacy and patient acceptance of an oral high dose of senna.
The investigative team compared this to conventional polyethylene glycol-electrolyte lavage solution in adults undergoing elective colonoscopy.
The investigators included consecutive outpatients referred for elective colonoscopy.
Patients were randomly assigned to receive 24 tablets of 12 mg senna, or 4L of standard solution the day before the procedure
The doses were taken at 2 times during the day, in the afternoon and evening
The overall quality of colon cleansing in the right colon was evaluated using the Aronchick scoring scale by the endoscopist.
|Overall cleansing was good in 97% with senna vs 80% with standard solution|
|American Journal of Gastroenterology|
The endoscopist was blinded to the treatment assignment.
Patient acceptance and the safety of the preparation was assessed by a nurse, using a structured questionnaire
The investigators found that the quality of colon cleansing, overall tolerance of the preparation, and compliance were significantly better with senna.
The overall cleansing was excellent or good in 97% of patients in the senna group and in 80% in the polyethylene glycol-electrolyte lavage solution group.
The team noted that 7% of the procedures were rescheduled because of insufficient colon cleansing in the polyethylene glycol-electrolyte lavage solution group.
Only 3% of the procedures were rescheduled in the senna group.
Multivariate logistic regression modeling showed the polyethylene glycol-electrolyte lavage solution as a negative independent predictor of unsuccessful bowel cleansing.
The incidence of adverse reactions was similar in the 2 groups
The investigators observed that patients who received senna experienced significantly less nausea and vomiting, but more abdominal pain.
Dr Radaelli's team concluded, “An oral high dose of senna is a valid alternative to standard polyethylene glycol-electrolyte lavage solution for outpatient colonoscopy preparation.”