title: A prospective audit of the efficacy, safety, and acceptability of low-volume polyethylene glycol (2 L) versus standard volume polyethylene glycol (4 L) versus magnesium citrate plus stimulant laxative as bowel preparation for colonoscopy.
abstract: BACKGROUND
  High-quality video colonoscopy requires adequate preparation of the bowel to ensure both adequate procedure completion rates and polyp detection rates. We sought to examine our practice to determine which bowel preparation cleansed most effectively in our patients.
  
  
  OBJECTIVE
  A prospective audit of the efficacy, safety, and acceptability of low-volume polyethylene glycol (2-L Moviprep; Norgine Pharmaceuticals) versus standard volume polyethylene glycol (4-L KleanPrep; Norgine Pharmaceuticals) versus magnesium citrate (Citramag; Sanochemia UK Ltd.) plus stimulant laxative as bowel preparation for colonoscopy.
  
  
  METHODS
  District General Hospital.
  
  
  METHODS
  Patients attending for day case colonoscopy.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Overall cleansing grades of preparations used: patient compliance, taste, and acceptability.
  
  
  METHODS
  A prospective audit of patient experience of taking bowel preparation and blinded colonic scoring assessment of bowel cleansing of each of the tested regimes.
  
  
  RESULTS
  A total of 258 (female,138; 53.5%) patients were recruited, 91 in the KleanPrep group (F:45, 49.5%), 86 patients in the Moviprep group (female, 45; 52.3%), and 81 in the Senna/Citramag group (female, 44; 54.3%). Significantly more patients were unable to take the prescribed dose of KleanPrep when compared with the other 2 regimes (19.6%; P<0.0001 vs. Moviprep; P<0.0001 vs. Senna/Citramag). A total of 45.65% of patients reported KleanPrep as tasting unpleasant. This was significantly more than both Moviprep (10.47%; P=0.008) and Senna/Citramag (9.88%; P<0.0001). The overall cleansing efficacy across the 3 groups (those with grades A or B) was 73.9%, 74.5%, and 86.5% for KleanPrep, Moviprep, and Senna/Citramag, respectively. In this series Senna/Citramag proved significantly better at bowel cleansing than KleanPrep (P<0.05) and it showed a trend toward better cleansing when compared with Moviprep (P=0.08).
  
  
  CONCLUSIONS
  Nonrandomized trial. Split-dosing regime for morning and afternoon lists may have confounded results.
  
  
  CONCLUSIONS
  In summary, low-volume PEG (Moviprep) and Senna/Citramag combination were better tolerated than large volume PEG with Senna/Citramag providing superior mucosal cleansing.
authors.affiliation: Department of Gastroenterology, Antrim Area Hospital, Belfast, Northern Ireland. nickkelly@doctors.net.uk
authors.forename: Nicholas Michael
authors.initials: NM
authors.lastname: Kelly
authors.forename: Colin
authors.initials: C
authors.lastname: Rodgers
authors.forename: Neil
authors.initials: N
authors.lastname: Patterson
authors.forename: Sudheer George
authors.initials: SG
authors.lastname: Jacob
authors.forename: Inder
authors.initials: I
authors.lastname: Mainie
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects; D019343:Citric Acid / Q000008:administration & dosage / Q000009:adverse effects; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D054368:Laxatives / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D012676:Senna Extract / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002400:Cathartics; D054368:Laxatives; C520497:MoviPrep; D009942:Organometallic Compounds; D019343:Citric Acid; D011092:Polyethylene Glycols; D012676:Senna Extract; C110422:magnesium citrate