Oral sodium phosphate solutions (e.g. Fleets PhosphoSoda®) were equally efficacious and shown to be better tolerated low volume alternatives to PEG (11). They were FDA approved for bowel cleansing and were been used extensively in select patients prior to colonoscopy until recently. However, on December 11, 2008, the FDA issued a statement concluding that the use of oral sodium phosphate preparations poses a risk of serious adverse events, notably acute phosphate nephropathy- a type of acute kidney injury- in select patients (patients over age 55, baseline kidney disease, on diuretics, angiotensin converting enzyme [ACE] inhibitors, NSAIDs or angiotensin-receptor blockers [ARBs] etc) (12-14). As a result, the FDA has required that manufacturers of oral sodium phosphate bowel preparations add a Boxed Warning to their labels of these products. Subsequently, these manufacturers have voluntarily removed their products from retail sale. There have been over 20 randomized controlled trials in the literature searching for the "ideal" bowel preparation (11). With the removal of oral sodium phosphate preparations from the market, the search for a better tolerated bowel cleansing regimen continues.