A randomised controlled trial of a new 2 litre polyethylene glycol solution versus sodium picosulphate + magnesium citrate solution for bowel cleansing prior to colonoscopy.
BACKGROUND
A new 2 L polyethylene glycol (PEG) solution containing ascorbic acid (Asc) and electrolytes (Moviprep) has been developed for bowel cleansing.


OBJECTIVE
To compare the efficacy, safety and acceptability of PEG + Asc versus sodium picosulphate + magnesium citrate in patients scheduled to undergo colonoscopy.


METHODS
This single blind, parallel group pilot study included 65 adult male and female patients. A blinded assessment of cleansing was made for each bowel segment by the colonoscopist and the scores determined an overall grading of bowel cleansing. Patients completed a questionnaire on the acceptability of the preparation.


RESULTS
Successful bowel preparation was reported in 84.4% of patients who received PEG + Asc and 72.7% of patients who received sodium picosulphate + magnesium citrate (treatment difference +11.6, 95% CI -11.2, +34.5; p = 0.367). Patients were more likely to have a higher overall quality of bowel cleansing with PEG + Asc (p = 0.018), with specifically better cleansing in the ascending colon (p = 0.024) and caecum (p = 0.003) compared with patients who received sodium picosulphate + magnesium citrate. The adverse event profile of the two treatments was similar, with headache and gastrointestinal effects being the most commonly reported. Some patient acceptability results favoured sodium picosulphate + magnesium citrate for those patients who had experience of previous bowel preparation, but were similar for those patients who had not had a previous bowel preparation.


CONCLUSIONS
PEG + Asc provided effective bowel cleansing, which was equivalent to that of sodium picosulphate + magnesium citrate in terms of grading cleansing as overall success or failure. In the proximal colon (ascending colon and caecum) PEG + Asc provided significantly better cleansing to that achieved with sodium picosulphate + magnesium citrate.
Worthington
J
J
Gastroenterology Department, John Radcliffe Hospital, Oxford, UK.
Thyssen
M
M
Chapman
G
G
Chapman
R
R
Geraint
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000494:pharmacology; D002400:Cathartics / Q000494:pharmacology*; D002951:Citrates; D019343:Citric Acid / Q000494:pharmacology*; D003106:Colon / Q000187:drug effects; D003113:Colonoscopy; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000494:pharmacology*; D010847:Picolines / Q000494:pharmacology*; D011092:Polyethylene Glycols / Q000494:pharmacology*; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation
D002400:Cathartics; D002951:Citrates; D009942:Organometallic Compounds; D010847:Picolines; D019343:Citric Acid; D011092:Polyethylene Glycols; C005701:picosulfate sodium; D001205:Ascorbic Acid; C110422:magnesium citrate