Gastroenterologists in Italy compared senna tablets to conventional PEG lavage as a preparation for screening colonoscopy. They rated overall colon cleansing, cleansing of the right colon, safety, and patient acceptance in a randomized study reported in the December issue American Journal of Gastroenterology.
Outpatients who had been referred for elective colonoscopy were randomly prescribed either 24 tablets of 12 mg. senna, taken in two doses on the day prior to colonoscopy or standard 4 liter polyethylene glycol-electrolyte solution (PEG-ES).
The gastroenterologist who performed the colonoscopy did not know which preparation the individual patient had used and evaluated the quality of colon cleansing. Patients answered questions about tolerance, discomfort, adverse events, and their ability to complete the entire preparation.
The quality of colon cleansing, overall tolerance of the prep technique, and compliance were significantly better with the senna group.
- overall cleansing was excellent or goo in 90.6% of senna patients compared to 79.7% of PEG-ES.
- 7.3% of PEG-ES patients had to be rescheduled for another colonoscopy because of insufficient cleansing compared to 2.8% of those using senna.
- incidence of adverse events was similar in the two groups, but patients receiving senna had significantly less nausea and vomiting, although they reported more abdominal pain.
The study team, headed by Franco Radaelli, M.D.concluded:
An oral high dose of senna is a valid alternative to standard PEG-ES for outpatient colonoscopy preparation.
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