Colonoscopy: the secret to easy preparation for the procedure

Fleet Phospho-Soda

The main thing in preparation is to cleanse the colon of feces. The cleanliness of the intestinal walls affects the quality and accuracy of the data obtained as a result of the examination, and therefore the correctness of the prescribed treatment. Therefore, it is important to prepare the intestines as best as possible. With the new drug Fleet Phospho-Soda, this has become much easier.

How does Fleet Phospho-Soda work?

Fleet Phospho-Soda is the first hyperosmolar solution in Russia designed to prepare the intestines for colonoscopy and surgical interventions. It has many advantages, but in terms of patient comfort, the main one is the reduced volume of fluid that needs to be drunk. Instead of the usual 4 liters, you will have to drink exactly 2 times less: 400 ml (2 glasses) of ginger-lemon solution and another 1.6 liters (6 glasses) of plain water. If we consider that the drug is taken in two doses (in accordance with the preparation regimen), the advantage becomes obvious.

Efficiency of Fleet Phospho-Soda

Experience shows that in those patients who prepared for colonoscopy using the drug Fleet Phospho-Soda, the number of repeat procedures decreased by 3 times compared to those who prepared using traditional methods. Colonoscopy is performed with excellent visualization, which means that the research data is as accurate as possible.

The drug is well tolerated - this is noted by all the doctors who prescribed it. The most important thing is to follow a diet and follow the instructions for use included with each package.

If your doctor recommends using Fleet Phospho-soda, you will see for yourself how much easier it is to prepare for a colonoscopy with this drug.

Phosphosoda, 2 pcs., 45 ml, oral solution

The drug is not used as a treatment for constipation.

Severe and potentially fatal cases of electrolyte imbalance have rarely developed in elderly patients treated with Phosphosoda. Before starting the use of Phospho-soda in this category of high-risk patients, it is necessary to carefully assess the risk-benefit ratio.

When prescribing Phospho-soda to any patient, special attention should be paid to known contraindications and the importance of adequate hydration; in addition, in high-risk patients (see sections “Contraindications”, “With caution”), it is important to measure the initial level of electrolyte concentrations and the level of electrolyte concentrations after using the drug Phospho-soda.

Dehydration (Dehydration)

This drug usually works within half an hour to 6 hours after taking it. If within 6 hours after taking Phospho-soda the patient has not had a single bowel movement, it is necessary to ask the patient to stop taking this drug and immediately contact the doctor, since dehydration may develop .

Patients should be warned that they should develop frequent loose stools. They should be asked to drink as much fluid as possible to avoid dehydration. Inadequate fluid intake when using any effective laxative can lead to excessive fluid loss with possible development of dehydration and hypovolemia. Dehydration and hypovolemia under the influence of a laxative may be exacerbated by insufficient oral fluid intake, nausea, vomiting, loss of appetite, or by the use of diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and nonsteroidal anti-inflammatory drugs (NSAIDs); in such a situation, acute renal failure may develop. Rare cases of acute renal failure have been reported with the use of laxatives, including sodium phosphate derivatives and polyethylene glycol (PEG)-3350.

Patients with conditions that may contribute to dehydration or who are receiving medications that may reduce the glomerular filtration rate should be assessed for hydration status before initiating bowel preparation with laxatives and appropriate measures should be taken.

Nephrocalcinosis

In rare cases, nephrocalcinosis with acute renal failure and deposition of calcium phosphate crystals in the renal tubules has been reported in patients taking sodium phosphate for bowel cleansing. Nephrocalcinosis is a serious adverse event that can cause irreversible deterioration of kidney function with the need for dialysis over a long period of time. Most cases of nephrocalcinosis occur in older women receiving antihypertensive drugs or other drugs (eg, diuretics or NSAIDs) that can cause dehydration.

When prescribing the drug Phospho-soda, it is necessary to follow the recommendations, and special attention must be paid to known contraindications and adequate replenishment of lost fluid.

Patients at risk

Caution should be exercised when using Phospho-soda in patients with an increased risk of renal dysfunction, existing electrolyte imbalance or an increased risk of developing it (for example, dehydration, gastric retention, colitis, inability to take sufficient oral fluids, hypertension or other conditions , in which patients receive drugs that can lead to dehydration (see section "Interaction with other drugs"), arterial hypotension with clinical manifestations or associated with hypovolemia; heart disease, acute myocardial infarction, unstable angina, as well as weakened patients and patients elderly Patients at risk should check the initial concentrations of sodium, potassium, calcium, chloride, bicarbonate, phosphate, plasma urea nitrogen and creatinine, and should also check the concentration of these indicators after using the drug.

Electrolyte imbalance

There is a risk of increased serum sodium and phosphate levels, as well as decreased calcium and potassium levels; thus, hypernatremia, hyperphosphatemia, hypocalcemia, hypokalemia and acidosis may develop.

Rarely, prolongation of the QT interval on the electrocardiogram may be observed as a result of electrolyte imbalance such as hypocalcemia or hypokalemia.

These changes are not clinically significant.

Slowing down peristalsis

The drug should be used with caution in patients with disorders accompanied by decreased peristalsis, after surgery on the gastrointestinal tract, or with other medical conditions that slow down peristalsis. This drug should be used with caution in patients with a colostomy or ileostomy, or on a salt-free diet, as electrolyte imbalance, dehydration, or acid imbalance may develop.

Focal changes

During endoscopy, single or multiple aphthae-like changes were observed on the mucous membrane of the sigmoid and rectum. These were either lymphoid follicles, or discrete inflammatory formations, or changes in the epithelium caused by the preparation. These abnormalities are not clinically significant and resolve spontaneously without treatment.

Sodium content

One 45 ml dose of Phospho-soda contains 5 g of sodium. Therefore, the possibility of potential harm to the health of patients who are on a low sodium diet (salt-free diet) must be considered.

Impact on the ability to drive vehicles and operate machinery.

Does not affect.

Sources

• Papadopoulos T. Commentary on: Injectable Filler Technique for Face Lifting Based on Dissection of True Facial Ligaments. // Aesthet Surg J - 2022 - Vol - NNULL - p.; PMID:33782682
• Cong LY., Duan J., Luo CE., Luo SK. Injectable Filler Technique for Face Lifting Based on Dissection of True Facial Ligaments. // Aesthet Surg J - 2022 - Vol - NNULL - p.; PMID:33300562
• Rohrich RJ, Narasimhan K. Long-Term Results in Face Lifting: Observational Results and Evolution of Technique. // Plast Reconstr Surg - 2016 - Vol138 - N1 - p.97-108; PMID:27348643
• Sahawatwong S., Sirithanabadeekul P., Patanajareet V., Wattanakrai P., Thanasarnaksorn W. A Novel Technique of Supra Superficial Musculoaponeurotic System Hyaluronic Acid Injection for Lower Face Lifting. // J Clin Aesthet Dermatol - 2016 - Vol9 - N2 - p.58-62; PMID:27047633
• Narasimhan K., Ramanadham S., Rohrich RJ. Reply: Face Lifting in the Massive Weight Loss Patient: Modifications of Our Technique for This Population. // Plast Reconstr Surg - 2015 - Vol136 - N3 - p.389e; PMID:26057024
• Valente DS., Padoin AV., Zanella RK. Face Lifting in the Massive Weight Loss Patient: Modifications of Our Technique for This Population. // Plast Reconstr Surg - 2015 - Vol136 - N3 - p.388e; PMID:25989299
• Narasimhan K., Ramanadham S., Rohrich RJ. Face lifting in the massive weight loss patient: modifications of our technique for this population. // Plast Reconstr Surg - 2015 - Vol135 - N2 - p.397-405; PMID:25626786

PHOSPHO-SODA (solution)

It turned out that this played an important role in the end.)
If you pay attention to the instructions, they indicate 2 methods of administration, depending on what time the next day you have a study or operation scheduled for. Despite the fact that my study was scheduled for the daytime - I adhered to the morning dosage regimen - this will ensure that the urge to defecate will definitely stop before the procedure and you will be calm the next morning, which will ultimately result in a “clean” » intestines.

Now directly about how I took Flit: on the day of administration I took a day off from work, at 09:30 I drank a glass of water, then 15 minutes later another one, at 10 am I took the first portion of the drug (mixed with 120 ml of water), and then I immediately drank a third glass of cold water. I agree with the previous authors of reviews - you shouldn’t strain the drug in your mouth, drink it in one sitting - then you will be able to minimize the sensations from the taste of Flit (vigorous salty-sour-bitter-sweet - that’s exactly how it seemed to me, but quite tolerable). Then drink another 1 liter of water within an hour - I took a glass every 15 minutes. This will speed up the effect of the drug. It worked on me in the first dose within 50 minutes. Then there were 4-6 urges, but not as powerful as the first. At 16:00 I took about 1 liter of strained chicken broth - this is permissible and at the same time eliminates my appetite. The second dose of the drug was exactly 12 hours after the first - at 22:00 - I think you should not deviate from this interval - since after all, the body must “assimilate” the first portion with the least harm. The second technique follows exactly the same scheme as the first. But since by the second serving the intestines were already fairly cleansed, get ready for the fact that the effect may come a little later. In my case it came in about 2 hours. At 2 o'clock in the morning I fell asleep and during the night I did not wake up to go to the toilet. In the morning I walked a couple of times with a small amount of clear liquid (by the way, the doctor told me that not everyone ends up with clear water - it may be yellow (due to bile) or with white flakes - but this is normal and does not mean that you are ill prepared). As for side effects, there were no side effects, with the exception of slight nausea after taking the first portion on an empty stomach, but it quickly subsided. Well, the next morning, my eyes were pretty swollen from drinking so much water.

May your colon cleansing procedure be hassle-free! To do this, the drug must be prescribed by your doctor, taking into account the characteristics of your body. Do not self-medicate.

I hope my review will be useful to someone! There was anxiety and excitement, but it all turned out to be in vain.) And take care of your health so that you don’t have to go through something like this!

Composition and release form

in PE bottles of 45 ml; There are 2 bottles in a cardboard pack.

special instructions

The drug should not be used as a treatment for constipation.

The drug should be used with caution in elderly, debilitated patients with reduced renal function, heart disease, colostomy, or on a low-salt diet, since there is a possibility of developing hyperphosphatemia, hypocalcemia, hypokalemia, dehydration due to hypernatremia, and acidosis.

The patient should be warned about the possibility of frequent loose stools.

Very rarely, during endoscopy, single or multiple aphthous-like changes were observed on the mucous membrane of the sigmoid and rectum: lymphoid follicles, discrete inflammatory formations, or changes caused by the preparation. These abnormalities are not clinically significant and resolve spontaneously without treatment.

Rarely, prolongation of the QT interval on the ECG may be observed as a result of electrolyte imbalance such as hypocalcemia or hypokalemia.

Impact on the ability to drive vehicles and operate machinery

The drug does not affect the ability to drive vehicles or operate machinery.

Interaction

The drug should be used with caution in patients taking CCBs, diuretics, lithium-based drugs and other drugs that can affect electrolyte levels, since there is a possibility of developing hyperphosphatemia, hypocalcemia, hypokalemia, dehydration due to hypernatremia, and acidosis.

During the period of taking the drug Fleet Phospho-soda, there may be a delay or cessation of drug absorption in the gastrointestinal tract. The effect of regularly taken medications (including antibiotics, oral contraceptives, antiepileptic and hypoglycemic drugs) may be reduced or absent altogether.

Directions for use and doses

Inside. The drug is used in adults and adolescents over 15 years of age. No dose adjustment is required for elderly patients.

You should start taking Flit Phosphosoda on the day before your scheduled endoscopic or x-ray procedure. If your appointment is scheduled before noon, it is recommended that you follow the instructions for a morning appointment. If your appointment is scheduled for the afternoon, it is recommended that you follow the instructions for an afternoon appointment.

Morning appointment

Day before the procedure

At 7 a.m., instead of breakfast, drink at least 1 glass of light liquid (water or soups freed from solid particles, fruit juices without pulp, tea and coffee, clear carbonated and non-carbonated soft drinks, etc.).

The first dose of the drug should be taken immediately after breakfast. The contents of 1 bottle should be dissolved in half a glass (120 ml) of cold water. (45 ml). Drink the prepared solution and wash it down with one (or more) glass (240 ml) of cold water.

At 1 p.m., instead of lunch, you should drink at least 3 glasses (720 ml) of light liquid.

At 19:00 instead of dinner, drink at least 1 glass of light liquid.

The second dose of the drug should be taken immediately after dinner. The contents of the second bottle (45 ml) should be dissolved in half a glass (120 ml) of cold water. Drink the prepared solution and wash it down with one (or more) glass (240 ml) of cold water.

If desired, you can drink more liquid. Light liquids can be drunk until midnight.

Day appointment

Day before the procedure

At 13:00 during lunch you can have a light snack. After lunch, you should not eat any solid food.

At 19:00, instead of dinner, you should drink 1 glass of light liquid. If desired, you can drink more liquid.

The first dose of the drug should be taken immediately after dinner. The contents of one bottle (45 ml) should be dissolved in half a glass (120 ml) of cold water. Drink the prepared solution and wash it down with one (or more) glass (240 ml) of cold water. If desired, you can drink more liquid.

During the evening you need to drink at least 3 glasses of light liquid.

Day of procedure

At 7 a.m., instead of breakfast, you should drink 1 glass of light liquid. If desired, you can drink more liquid.

The second dose of the drug should be taken immediately after breakfast. The contents of one bottle (45 ml) should be dissolved in half a glass (120 ml) of cold water. Drink the prepared solution and wash it down with one (or more) glass (240 ml) of cold water.

Light liquids can be consumed up to 8 hours.

This drug usually causes bowel movements within half an hour to 6 hours.

Side effects

From the digestive system: nausea, vomiting, abdominal pain, bloating, diarrhea; very rarely - during endoscopy on the mucous membrane of the sigmoid and rectum - single or multiple aphthae-like formations can be observed (clinically insignificant, disappear spontaneously without treatment).

From the side of the central nervous system: asthenia, weakness, headache, dizziness.

From the metabolic side: in some patients at risk - dehydration and/or electrolyte imbalance (including hyperphosphatemia, hypocalcemia, hypokalemia, hypernatremia, acidosis).

Other: allergic reactions.