Colon cleansing compositions and methods

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). ...

AI Technical Summary

Benefits of technology

[0111] Furthermore, the composition of the invention was better accepted than PEG+E, which acceptance is related to the improved taste and lower volume to be taken. In addition, NRL994 was shown to be as safe as PEG+E in a patient group that is enhanced for risk factors (hospitalised patients). Moreover, the comparison with NaP indicated an improved safety profile for the composition of the invention without clinically significant electrolyte alterations or disturbances. Overall, the composition of the invention provides an effective and safe bowel cleansing procedure with patient compliance equivalent to that with NaP. Furthermore, the composition of the invention avoids the need to limit its use to younger and more healthy subjects undergoing a routine colonoscopy, as required by NaP.

[0112] Accordingly, a composition of the present invention may be used to treat patient populations for which PEG+E or especially, NaP, would be considered unsuitable or unsafe; for example, outpatients, young and old patients, and patients having clinical conditions that would make them unsuitable for treatment, especially with NaP.

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.