title: Bowel preparation for performing a colonoscopy: prospective randomized comparison study between a low-volume solution of polyethylene glycol and bisacodyl versus bisacodyl and a mannitol solution.
abstract: BACKGROUND
  Colonoscopy is currently the gold standard method to examine the colon, the rectum and the terminal ileum. In order to perform the colonoscopy, it is necessary to clean the bowel and use medications that are generally poorly tolerated by the patients.
  
  
  OBJECTIVE
  Compare the tolerability, acceptability, safety and efficacy of two solutions used for intestinal preparation for a colonoscopy.
  
  
  METHODS
  One hundred patients matched for sex and age were prospective randomized into two groups. Polyethylene glycol group received bisacodyl 10 mg plus 1 L of polyethylene glycol the night before and 1 L on the day of the exam. Mannitol group received bisacodyl 20 mg the day before and 1 L of a 10% mannitol solution on the day of the exam. The diet was the same for both groups. Tolerability and acceptability were measured using previously validated questionnaires. In terms of safety, variations in vital signs before and after the preparation were recorded, in addition to any complications. The quality of the preparation was graded based on the Boston and Ottawa scales.
  
  
  RESULTS
  Ninety-six percent (96%) completed the study. As for tolerability, the mannitol preparation group exhibited a significantly higher frequency of nausea, vomiting, abdominal pain, and abdominal distension than polyethylene glycol group (P < 0.05). Acceptability was significantly better in polyethylene glycol group. The polyethylene glycol solution has also previously been shown to be safer than mannitol. No difference was observed in the quality of the preparation between the two preparation methods.
  
  
  CONCLUSIONS
  The following conclusions can be made: polyethylene glycol solution had higher tolerability, acceptability, and safety than the mannitol and should be used instead of mannitol. Both preparation solutions have similar efficacy.
authors: Diagnostic Center of Gastroenterology, Department of Gastroenterology, Hospital das Clínicas University of São Paulo School of Medicine, São Paulo, SP, Brazil. manoel02@hotmail.com
authors: Manoel Carlos
authors: MC
authors: Vieira
authors: Claudio Lyoiti
authors: CL
authors: Hashimoto
authors: Flair José
authors: FJ
authors: Carrilho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001726:Bisacodyl / Q000008:administration & dosage* / Q000009:adverse effects; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy / Q000379:methods*; D006801:Humans; D008353:Mannitol / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D002400:Cathartics; D001726:Bisacodyl; D008353:Mannitol; D011092:Polyethylene Glycols