Effective strategies for stool regulation in surgical patients: The focus is on sodium picosulfate

According to statistics, up to 20% of the adult population in different countries suffers from constipation. In surgical practice, constipation presents two pressing challenges for surgeons: diagnostic, in terms of differential diagnosis of possible causes, and therapeutic. The first part of the review article examines possible diseases and conditions encountered in real-life surgical practice, whose clinical presentation includes constipation. The key to an accurate diagnosis and successful subsequent treatment is optimal patient preparation for colonoscopy. The use of sodium picosulfate in various bowel preparation regimens for colonoscopy promotes better tolerability and a successful colonoscopy. Sodium picosulfate is one of the most commonly used and effective medications and belongs to the group of synthetic stimulant laxatives. The second part of the review article, based on a search of Pubmed, Scopus, and eLIBRARY.RU databases, examines articles published before July 15, 2025, examining the efficacy and safety of sodium picosulfate, with a focus on surgical practice. The use of sodium picosulfate has demonstrated its effectiveness and safety in atonic constipation, for stool regulation (hemorrhoids, proctitis, anal fissures), for preparation for surgical operations, instrumental and radiological examinations, and in the postoperative period during prolonged immobilization. Sodium picosulfate is considered as the drug of choice in various categories of patients, including those with comorbidities, since it is not absorbed into the systemic circulation, so the combination with other drugs is safe and effective.

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