title: Effectiveness of Sodium Picosulfate/Magnesium Citrate (PICO) for Colonoscopy Preparation.
abstract: OBJECTIVE
  Bowel preparation with sodium phosphate was recently prohibited by the U.S. Food and Drug Administration. Polyethylene glycol (PEG) is safe and effective; however, it is difficult to drink. To identify an easy bowel preparation method for colonoscopy, we evaluated three different bowel preparation regimens regarding their efficacy and patient satisfaction.
  
  
  METHODS
  In this randomized, comparative study, 892 patients who visited a secondary referral hospital for a colonoscopy between November 2012 and February 2013 were enrolled. Three regimens were evaluated: three packets of sodium picosulfate/magnesium citrate (PICO, group A), two packets of PICO with 1 L of PEG (PICO + PEG 1 L, group B), and two packets of PICO with 2 L of PEG (PICO + PEG 2 L, group C). A questionnaire survey regarding the patients' preference for the bowel preparation regimen and satisfaction was conducted before the colonoscopies. The quality of bowel cleansing was scored by the colonoscopists who used the Aronchick scoring scale and the Ottawa scale.
  
  
  RESULTS
  The patients' satisfaction rate regarding the regimens were 72% in group A, 64% in group B, and 45.9% in group C. Nausea and abdominal bloating caused by the regimens were more frequent in group C than in group A or group B (P < 0.01). Group C showed the lowest preference rate compared to the other groups (P < 0.01). Group C showed better right colon cleansing efficacy than group A or group B.
  
  
  CONCLUSIONS
  Group A exhibited a better result than group B or group C in patient satisfaction and preference. In the cleansing quality, no difference was noted between groups A and C.
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Ki Hwan
authors.initials: KH
authors.lastname: Song
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Wu Seok
authors.initials: WS
authors.lastname: Suh
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Jin Sik
authors.initials: JS
authors.lastname: Jeong
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Dong Sik
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Dong Min
authors.initials: DM
authors.lastname: Kwak
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Jong Seong
authors.initials: JS
authors.lastname: Hwang
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Man Woo
authors.initials: MW
authors.lastname: Park
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Shim
authors.affiliation: Coloproctology Center, Goo Hospital, Daegu, Korea.
authors.forename: Ja-Il
authors.initials: JI
authors.lastname: Koo
authors.affiliation: Department of Surgery, Yeungnam University School of Medicine, Daegu, Korea.
authors.forename: Jae Hwang
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Hwanggeumbit Hakmoon Colorectal Surgery Clinic, Daegu, Korea.
authors.forename: Dae Ho
authors.initials: DH
authors.lastname: Shon
keywords: Bowel preparation; Colonoscopy; Polyethylene glycols; Satisfaction; Sodium picosulfate magnesium citrate