MiraLAX-Gatorade bowel prep versus GoLytely before screening colonoscopy: an endoscopic database study in a community hospital.
BACKGROUND
Polyethylene glycol-3350 without electrolytes (MiraLAX; Schering-Plough Healthcare Products Inc.)+a carbohydrate-electrolyte solution (Gatorade; PepsiCo Inc.)+bisacodyl is frequently used for bowel cleansing, although limited data quantifies its efficacy and safety. No prior studies have assessed this in a community setting or with PM-only dosing, which is still used frequently.


OBJECTIVE
To compare the frequency of excellent/good/fair/poor bowel cleansing with PM-only dosing of MiraLAX-Gatorade-bisacodyl versus 4-liter GoLytely.


METHODS
This is a retrospective endoscopic database analysis of 50 years and older average-risk individuals with a normal screening colonoscopy at a community hospital and ambulatory endoscopy center. Data were extracted for the last 4 months when 4-liter GoLytely was the preferred bowel purgative and the first 4 months when 238-g MiraLAX in 64-ounce Gatorade and four 5-mg bisacodyl tablets became the preferred purgative. All patients used PM-only dosing of bowel purgative.


RESULTS
A total of 778 subjects [GoLytely (n=395) vs. MiraLAX+Gatorade+bisacodyl (n=383)] were identified. Patients who took the MiraLAX bowel preparation were more likely to achieve an excellent/good bowel cleansing compared with patients taking the GoLytely preparation (93.3% vs. 89.3%, respectively; P=0.048). However, when only American Society of Anesthesiology (ASA) class I patients are studied, there was no difference in frequency of excellent/good bowel cleansing (91.1% vs 93.6%, respectively; P=0.498). No serious adverse events were identified. An excellent/good bowel cleansing was strongly associated with a recommendation for repeat colonoscopy in 10 years compared with patients with a fair cleansing (odds ratio=28.01; 95% confidence interval, 13.96-56.19).


CONCLUSIONS
The MiraLAX+Gatorade+bisacodyl combination produces similar rates of excellent/good bowel cleansing as compared with GoLytely in most average-risk individuals undergoing colonoscopy for colorectal screening in a community setting.
Department of Internal Medicine, University of Michigan School of Medicine, MI, USA.
Frederick K
FK
Shieh
Naresh
N
Gunaratnam
Sagal O
SO
Mohamud
Philip
P
Schoenfeld
D000368:Aged; D001726:Bisacodyl / Q000008:administration & dosage; D002400:Cathartics / Q000008:administration & dosage*; D003113:Colonoscopy / Q000379:methods* / Q000592:standards; D016001:Confidence Intervals; D055088:Early Detection of Cancer / Q000379:methods; D004573:Electrolytes / Q000008:administration & dosage*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D012189:Retrospective Studies
D002400:Cathartics; D004573:Electrolytes; C033608:Golytely; D007552:Isotonic Solutions; C011259:gatorade; D001726:Bisacodyl; D011092:Polyethylene Glycols