Prospective, randomized comparison of same-day dose of 2 different bowel cleanser for afternoon colonoscopy: picosulfate, magnesium oxide, and citric acid versus polyethylene glycol

Medicine (Baltimore). 2015 Apr;94(13):e628. doi: 10.1097/MD.0000000000000628.

Abstract

For afternoon colonoscopy, same-day administration of sodium picosulfate, magnesium oxide, and citric acid (PM/Ca) is recommended. However, few studies have evaluated the bowel-cleansing efficacy and safety of this regimen. The aim of this study was to compare the bowel-cleansing efficacy, side effects, and patient's tolerability of a same-day split administration of PM/Ca with polyethylene glycol (PEG) for afternoon colonoscopy. Patients were randomly assigned to a PM/Ca group or a PEG group. The PM/Ca group consumed 1 sachet of PM/Ca at 06:00 and 1 sachet of PM/Ca 4 hours before the colonoscopy. They also took 2 tablets of bisacodyl before sleep on the night before. The PEG group consumed 2 L of PEG at 06:00 and 2 L of PEG 4 hours before the colonoscopy. All subjects were instructed to finish the bowel cleanser or fluid at least 2 hours before colonoscopy. All colonoscopic examinations were performed in the afternoon on the same day. The bowel-cleansing efficacy was scored using 2 scales: the Ottawa Bowel Preparation Scale (OBPS) and the Aronchick scale. Ease of using the bowel cleanser was rated from 1 (very easy) to 5 (very difficult). Two hundred nine patients underwent colonoscopy. The bowel-cleansing scores by OBPS did not differ between groups (5.0 vs 4.9, P = 0.63). Ease of using the bowel cleanser was superior in the PM/Ca group (P < 0.01). The cleansing efficacy of PM/Ca administered on the day of colonoscopy is comparable to that of PEG. Patients prefer PM/Ca.

Publication types

  • Clinical Trial, Phase III
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bisacodyl / therapeutic use
  • Cathartics / administration & dosage
  • Cathartics / adverse effects
  • Cathartics / therapeutic use*
  • Citrates / therapeutic use
  • Citric Acid / therapeutic use
  • Colonoscopy / methods*
  • Female
  • Humans
  • Magnesium Oxide / therapeutic use
  • Male
  • Middle Aged
  • Organometallic Compounds / therapeutic use
  • Picolines / therapeutic use
  • Polyethylene Glycols / therapeutic use
  • Prospective Studies
  • Single-Blind Method

Substances

  • Cathartics
  • Citrates
  • Organometallic Compounds
  • Picolines
  • Bisacodyl
  • Citric Acid
  • Magnesium Oxide
  • Polyethylene Glycols
  • picosulfate sodium