Pico-Salax versus polyethylene glycol for bowel cleanout before colonoscopy in children: a randomized controlled trial.
OBJECTIVE
Comparison of bowel preparation for colonoscopy in children with either Pico-Salax (sodium picosulphate with magnesium citrate) or polyethylene glycol with electrolyte solution (PEG-ELS).


METHODS
In this investigator-blinded, randomized controlled trial, 83 children (12.5 +/- 3.1 years) requiring elective colonoscopy at a referral hospital were randomly allocated to Pico-Salax (n = 43) or PEG-ELS (n = 40), and an intention-to treat analysis was applied. Pico-Salax was administered in two doses, one the evening before and one on the morning of the procedure. PEG-ELS was administered over 4 hours. Efficacy was scored using the Ottawa scale and other constructs. Tolerability and toxicity were measured by patient and nursing questionnaires and serum biochemistry.


RESULTS
35 of Pico-Salax patients (81 %) were satisfied or very satisfied with the cleanout, compared with 19 (48 %) in the PEG-ELS group (P = 0.001). No differences were found in bowel cleanout effectiveness, as judged by the Ottawa score (P = 0.24), completion rates (P = 0.69), colonoscopy duration (P = 0.59), need for enemas (P = 0.25), or physician's global impression (P = 0.7). Except for one case of mild dehydration in the Pico-Salax group, no clinically significant adverse events were recorded. Serum biochemistry results were similar between groups except for more hypermagnesemia associated with Pico-Salax and hypokalemia with PEG-ELS; neither was clinically significant.


CONCLUSIONS
Children tolerate Pico-Salax better than PEG-ELS for bowel cleanout before colonoscopy. This study did not demonstrate superiority of effectiveness or safety for either regimen.
Turner
D
D
Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Canada. turnerd@szmc.org.il
Benchimol
E I
EI
Dunn
H
H
Griffiths
A M
AM
Frost
K
K
Scaini
V
V
Avolio
J
J
Ling
S C
SC
D000284:Administration, Oral; D000293:Adolescent; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D002648:Child; D002675:Child, Preschool; D002951:Citrates; D019343:Citric Acid / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D003113:Colonoscopy; D004311:Double-Blind Method; D016527:Drug Costs; D005260:Female; D006801:Humans; D008277:Magnesium Oxide / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D008297:Male; D009942:Organometallic Compounds; D017060:Patient Satisfaction; D010847:Picolines / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics
D002400:Cathartics; D002951:Citrates; D009942:Organometallic Compounds; C574900:Pico-Salax; D010847:Picolines; D019343:Citric Acid; D008277:Magnesium Oxide; D011092:Polyethylene Glycols; C005701:picosulfate sodium