title: Comparison of polyethylene glycol vs sodium picosulphate vs sodium biphosphonate by efficacy in bowel cleansing and patients' tolerability: a randomised trial.
abstract: BACKGROUND
  Adequate bowel preparation is necessary for a complete colonoscopy. Polyethylene glycol-electrolyte oral solution (PEG-EOS), sodium picosulphate (SS) and sodium biphosphonate (SP) are the three most commonly used purgative agents. We aimed to determine their efficacy and tolerability compared to each other in a randomised study.
  
  
  METHODS
  313 patients were randomly assigned to receive either PEG-EOS, SS or SP. Patients completed a tolerability score pre-colonoscopy. A cleanliness score was used to document adequacy of bowel preparation. A separate group of patients completed taste scores for the three cathartic agents before and after addition of flavour.
  
  
  RESULTS
  PEG-EOS was the worst-tolerated regimen but achieved the highest rates of right colonic cleansing and the lowest rate of incomplete colonoscopies. There were no statistical differences in the rates of rectosigmoid and mid-gut cleansing among the three agents. SS was by far the preferred purgative in the taste assessment study. Addition of flavour increased significantly taste scores for PEG-EOS.
  
  
  CONCLUSIONS
  For adequate bowel cleansing PEG-EOS is the most effective but is the least tolerated and least preferred among patients. Addition of flavour increases significantly patients' acceptance of PEG-EOS.
authors.affiliation: Department of Gastroenterology and Hepatology, St Luke's Hospital, Kilkenny, Ireland. heetunz@gmail.com.
authors.forename: Z
authors.initials: Z
authors.lastname: Heetun
authors.affiliation: Department of Gastroenterology and Hepatology, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Crowley
authors.affiliation: Department of Gastroenterology and Hepatology, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: F
authors.initials: F
authors.lastname: Zeb
authors.affiliation: Department of Gastroenterology and Hepatology, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: D
authors.initials: D
authors.lastname: Kearns
authors.affiliation: Department of Gastroenterology and Hepatology, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: M H
authors.initials: MH
authors.lastname: Brennan
authors.affiliation: Department of Gastroenterology and Hepatology, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: O'Connor
authors.affiliation: Department of Gastroenterology and Hepatology, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: G
authors.initials: G
authors.lastname: Courtney
authors.affiliation: Department of Gastroenterology and Hepatology, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: A R
authors.initials: AR
authors.lastname: Aftab
mesh_terms: D002400:Cathartics / Q000627:therapeutic use*; D002951:Citrates / Q000627:therapeutic use*; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D010847:Picolines / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D012964:Sodium / Q000627:therapeutic use*
chemical_list: D002400:Cathartics; D002951:Citrates; D009942:Organometallic Compounds; D010847:Picolines; D011092:Polyethylene Glycols; D012964:Sodium; C005701:picosulfate sodium
keywords: Colonic preparation; Colonoscopy; Polyethylene glycol-electrolyte oral solution; Sodium biphosphonate; Sodium picosulphate