title: The quest for a more acceptable bowel preparation: comparison of a polyethylene glycol/electrolyte solution and a mannitol/Picolax mixture for colonoscopy.
abstract: Eighty-nine consecutive patients attending for day-case colonoscopy were randomly allocated either polyethylene glycol/balanced electrolyte (PEG) mixture (n = 45) or a mannitol/Picolax mixture (n = 44). Both preparations were administered in two fractions. Patients recorded their experience of the preparation on a questionnaire and one of two experienced endoscopists (unaware of the type of preparation given) assessed the result of bowel cleansing. Carbon dioxide insufflation was used for all examinations. Good/excellent bowel cleansing occurred in significantly more patients given PEG, 43 (96%), than those allocated mannitol/Picolax, 34 (77%), p = 0.01. More patients receiving mannitol/Picolax were able to complete the preparation in full than patients receiving PEG (38 vs 27, p = 0.01). More patients found the taste of mannitol/Picolax pleasant compared to PEG (46% vs 20%). Both preparations had a similar side-effect profile. Of those patients tested, 13% receiving mannitol/Picolax had a postural drop in blood pressure and blood parameters suggestive of mild dehydration. A fractionated administration of PEG as a bowel preparation for day-case colonoscopy is well tolerated and superior as a cleansing agent to a mannitol/Picolax combination. Provided carbon dioxide is used as the insufflating agent, mannitol/Picolax is an acceptable alternative in fit, young patients intolerant of PEG.
authors.affiliation: Department of Endoscopy, St Mark's Hospital, London, UK.
authors.forename: B P
authors.initials: BP
authors.lastname: Saunders
authors.forename: T
authors.initials: T
authors.lastname: Masaki
authors.forename: M
authors.initials: M
authors.lastname: Fukumoto
authors.forename: S
authors.initials: S
authors.lastname: Halligan
authors.forename: C B
authors.initials: CB
authors.lastname: Williams
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002951:Citrates; D003113:Colonoscopy; D003631:Day Care, Medical; D004338:Drug Combinations; D004733:Enema; D006801:Humans; D008353:Mannitol / Q000008:administration & dosage*; D008875:Middle Aged; D009942:Organometallic Compounds; D010847:Picolines / Q000008:administration & dosage*; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D013649:Taste; D007507:Therapeutic Irrigation
chemical_list: D002951:Citrates; D004338:Drug Combinations; D009942:Organometallic Compounds; D010847:Picolines; D008353:Mannitol; D011092:Polyethylene Glycols; C005701:picosulfate sodium