Randomized clinical trial comparing sodium picosulfate with mannitol on the preparation FOR colonoscopy in hospitalized patients.
BACKGROUND
The cleansing of the colon for a colonoscopy exam must be complete so as to allow the visualization and inspection of the intestinal lumen. The ideal cleansing agent should be easily administered, have a low cost, and minimum collateral effects. Sodium picosulfate together with the magnesium citrate is a cathartic stimulant and mannitol is an osmotic laxative, both usually used for this purpose.


OBJECTIVE
Assess the colon cleanliness comparing the use of mannitol and sodium picosulfate as well as evaluate the level of patient satisfaction, the presence of foam, pain, and abdominal distension in hospitalized patients undergoing colonoscopy.


METHODS
A prospective, randomized, single-blind study with 80 patients that compared two groups: mannitol (40) and sodium picosulfate (40). Both groups received the same dietary orientation. The study was approved by the hospital's Ethics and Research Committee. The endoscopist was blind to the type of preparation. Outcomes evaluated: level of the colons cleanliness, patients satisfaction, the presence of foam, abdominal pain and distension, and the duration of the exam. The data was analyzed by means of the chi-squared test for proportions and Mann-Whitney for independent samples.


RESULTS
There were no statistically significant differences between the groups in relation to the level of the colon's cleanliness, patients satisfaction, the presence of foam, abdominal pain, and the duration of the exam. Fifteen percent of the exams of the mannitol group were interrupted while from the sodium picosulfate group it was 5%. The presence of foam was similar for both groups. The average duration for carrying out the exam was 28.44 minutes for the mannitol group and 35.59 minutes for the sodium picosulfate group. Abdominal distension was more frequent in the mannitol group. If they would have to do the same exam, the answer was that 80% said yes from the mannitol group and 92.5% from the sodium picosulfate group.


CONCLUSIONS
The quality of the colon preparation, foam formation, exam duration, and the collateral effects (nauseas, vomiting, and abdominal pain) were similar in both kinds of preparations. Abdominal distension was greater in the mannitol group. Both methods of preparation were well accepted by the hospitalized patients.
Digestive Endoscopy Unit, Gastroenterology Division, Hospital de Clínicas de Porto Alegre, RS, Brazil. sumuller@uol.com.br
Suzana
S
Müller
Carlos Fernando de Magalhães
CF
Francesconi
Ismael
I
Maguilnik
Helenice Pankowsky
HP
Breyer
D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects; D002951:Citrates; D003106:Colon / Q000187:drug effects; D003113:Colonoscopy; D004733:Enema; D005260:Female; D006801:Humans; D008297:Male; D008353:Mannitol / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009942:Organometallic Compounds; D017060:Patient Satisfaction; D010847:Picolines / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors
D002400:Cathartics; D002951:Citrates; D009942:Organometallic Compounds; D010847:Picolines; D008353:Mannitol; C005701:picosulfate sodium