Description

This combination product is a balanced electrolyte solution containing Polyethylene Glycol (PEG), a non-absorbable polymer, along with key electrolytes: Sodium Chloride (NaCl), Potassium Chloride (KCl), and Sodium Bicarbonate (NaHCO3​). This specific formulation is designed to be reconstituted with water to create an oral solution.

The primary component, PEG, is a potent osmotic laxative. The added electrolytes are crucial for maintaining the body’s fluid and electrolyte balance during the process of bowel evacuation, preventing dehydration and electrolyte imbalances.

Indications

This combination is primarily used for two main purposes:

1. Bowel Cleansing: Its most common use is for complete bowel evacuation and cleansing before colonoscopy, surgery, or other medical procedures that require a clean colon.

2. Chronic Constipation: It can also be used as a treatment for chronic constipation, particularly in cases that have not responded to a high-fiber diet or other laxatives.

Mechanism of Action

The therapeutic effect of this combination is based on the distinct roles of its components, working together to cleanse the bowel while maintaining the body’s physiological balance.

1. Polyethylene Glycol (PEG) – Osmotic Action:
   • PEG is a long-chain polymer that is not absorbed by the intestines.
   • When taken orally, it passes through the digestive tract, drawing large volumes of water into the lumen of the bowel via osmosis.

• • The increased volume of fluid in the intestines softens the stool and promotes a strong peristaltic reflex, which leads to a rapid and thorough evacuation of the bowel.

2. Electrolytes (NaCl, KCl, NaHCO3​) – Balancing Action:
   • During rapid and extensive bowel movements, the body can lose significant amounts of electrolytes and water, which could lead to dehydration and imbalances.

• • The combination of Sodium Chloride, Potassium Chloride, and Sodium Bicarbonate in the solution is formulated to be iso-osmotic.
  • By providing these electrolytes in a balanced concentration, the solution ensures that the osmotic pressure inside the bowel is similar to that of the body’s fluids.
  • This prevents the net absorption or secretion of electrolytes from the body into the bowel, thereby minimizing the risk of dehydration and electrolyte disturbances (such as low sodium or low potassium) during the cleansing process.

In summary, the PEG acts as the primary osmotic agent to induce a powerful laxative effect, while the electrolytes prevent the complications of dehydration and electrolyte imbalance that can arise from rapid fluid loss. This dual mechanism ensures that the bowel is effectively cleansed in a physiologically safe manner.