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Colon cleansing compositions and methods

a technology of compositions and colons, applied in the field of colon evacuants or colon cleansing compositions, orthostatic lavage solutions, can solve the problems of time-consuming dietary manipulation and laxatives, unpleasant enemas for patients, and various drawbacks of methods

Inactive Publication Date: 2007-05-03
NORGINE BV
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

"The present invention relates to improved methods and compositions for cleaning the gastrointestinal tract prior to various medical procedures. The invention aims to overcome the drawbacks of traditional methods such as dietary manipulation and enemas, which can be time-consuming and unpleasant for patients. The invention provides a solution that is faster, more effective, and has a less salty taste, making it easier for patients to consume. The invention involves the use of orthostatic lavage solutions or colon evacuants, which are liquids that are ingested to clean the colon. These solutions are designed to promote bowel movement and can be used as a pre-procedural cleaning method. The invention also includes a reduced sodium sulphate solution that is less salty and more effective in cleansing the gastrointestinal tract."

Problems solved by technology

Those methods suffer from various drawbacks.
Dietary manipulation and laxatives are time consuming; enemas are unpleasant for the patient; and dangerous salt and water losses may occur with cathartics, enemas and with sodium phosphate solutions.
If the water is not taken, elevated serum sodium and phosphate levels may result, leading to serious kidney problems.
The risk of those side effects makes it necessary for there to be direct medical supervision during administration of Phospho-soda.
Consumption of the solution results in volume-induced diarrhoea and thus cleansing of the colon.
However, as a significant percentage of such saline-based lavage solutions is absorbed into the bloodstream in the gut of the patient, a rapid increase in intravascular volume results, which has caused serious complications in some patients.
The GoLYTELY solution, whilst effective, has a very salty taste, which adversely affects patient compliance.
Consumption of such large volumes of fluid can also affect compliance adversely.
Ingestion of such volumes of gut lavage solution is generally physically unpleasant or even impossible for many patients, may result in retching, and is time consuming.
The unpleasant taste exacerbates the problem of patient compliance, particularly when the patient is not under medical supervision.
Ingestion of such volumes of gut lavage solution is still generally physically unpleasant or, for some patients, even impossible, may result in retching, and is time consuming.

Method used

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Examples

Experimental program
Comparison scheme
Effect test

example 1

Comparison of Effectiveness of 2-litre Solutions of Movicol, Movicol+Ascorbic Acid and Movicol +Ascorbic Acid +Sodium Sulphate

[0118] 6 healthy volunteers were given a 2 litre dose of each of A) Movicol, B) Movicol +ascorbic acid and C) Movicol+ascorbic acid+sodium sulphate and the volume of stools produced was measured. Movicol is a registered trademark of Norgine Limited and it is used in connection with a product of the formulation given in Table 2 below. The trial was carried out as a double blind cross-over study with 2 running periods for formulations A and B. Each volunteer was given formulation A and formulation B once each in a random order. The volunteers and the administering medical professional were blinded regarding which formulation was administered first. A third, open, study period was added for the investigation of formulation C. The composition of Movicol is shown in Table 2. The compositions of the three formulations are shown in Table 3.

TABLE 2Composition per l...

example 2

Comparison of Compositions of the Invention

[0130] A trial was carried out to investigate the effect on the efficacy of the cleansing solutions of the invention of altering, independently, the quantities of the PEG, sodium sulphate and ascorbic-acid components. Six compositions were investigated. The formulations were made up as aqueous solutions comprising compositions, A to F. The amount of each component in compositions A to F per litre of formulation is shown in Table 6.

TABLE 6Compositions A to F of the inventionIngredient (g)SodiumSodiumOsmolarityComp.PEG 3350SulphateAscorbic AcidAscorbateNaClKClmOsmol / kgA1007.50.00.02.6911.058308B1007.55.00.02.6911.058337C1007.55.05.02.6911.058379D1007.510.00.02.6911.058365E1005.05.05.02.6910.819329F1257.55.05.03.2171.155416

NB All compositions were lemon flavoured. The lemon flavouring was Ungerer Lemon SDF obtained from RSSL Pharma.

[0131] Composition E (containing 100 g PEG, 5 g sodium sulphate, 5 g ascorbic acid, 5 g sodium ascorbate, ele...

example 3

Study of Ingestion of Colon Cleansing Composition Interspersed with Water Ingestion

[0168] Ten subjects were enrolled for the study and written informed consent was given before its commencement. Each volunteer was given 2 litres of composition D as defined in Example 2. The composition was administered according to two different modes of administration on two different occasions separated by a wash-out period. In administration mode 1, the volunteer drank 2 litres of composition D within 2 hours as in the case of Example 2. According to administration mode 2 the volunteer drank 1 litre of composition over 1 hour, followed by 500 ml water over the next hour, followed by a second litre of composition over the following hour, followed by 1000 ml water over the following 2 hours.

[0169] Stools were collected over the 8 hours following commencement of the administration. A comparison of stool weights obtained by the two modes of administration is shown in Table 21.

TABLE 21Comparison of...

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PUM

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Abstract

A composition comprising, per litre of aqueous solution, from 30 to 350 g polyethylene glycol, from 3 to 20 g of an ascorbic acid component selected form the group consisting of ascorbic acid, a salt of ascorbic acid, or a mixture thereof, an alkali metal or alkaline earth metal sulphate, preferably from 1 to 15 g thereof, and optionally one or more electrolytes selected from sodium chloride, potassium chloride, and sodium hydrogen carbonate, and preferably also comprising flavourings, is effective in cleansing the gut in preparation for a endoscopy, especially colonoscopy. It is safer than conventional sodium phosphate-based gut cleansing compositions, and hence can be used for patients who would be at risk with sodium phosphate-based compositions, and is better tolerated than conventional PEG-based compositions, leading to better patient compliance and enabling effective out-patient use.

Description

[0001] The present application claims priority to co-pending British application number GB 0224909.2, filed Oct. 25, 2002, the disclosure of which application is specifically incorporated herein by reference without disclaimer. FIELD OF THE INVENTION [0002] The present invention relates to orthostatic lavage solutions, colon evacuants or colon cleansing compositions, also known as lavage compositions for cleansing the gastrointestinal tract, and methods of use of such compositions. GENERAL BACKGROUND [0003] Colon cleansing is important prior to numerous diagnostic and surgical procedures, for example before colonoscopy, barium enema examination or colon surgery. It is also useful for preventing infection after surgery on the lower intestine. Colon cleansing is also known as colon clearing. [0004] A variety of methods for colon cleansing are known. Dietary manipulation, laxatives, cathartics and enemas were traditionally used (Thomas, G. et al., Gastroenterology, 1982, 82, 435-437). ...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61K31/765A61K47/00A61K33/14A61K31/375A61K9/00A61K33/00A61K33/04A61K33/06
CPCA61K9/009A61K9/0095A61K31/375A61K31/765A61K33/00Y10S514/892A61K33/06A61K33/14A61K45/06A61K33/04A61K2300/00A61P1/00A61P1/10A61P31/00A61K9/08A61K47/02A61K47/22
Inventor BARRAS, NORMANCOX, IAN DAVID
Owner NORGINE BV
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