Comparison of Two Bowel Preparations for Colonoscopy: Sodium Picosulphate With Magnesium Citrate Versus Sulphate-Free Polyethylene Glycol Lavage Solution

Regev, Arie; Fraser, Gerald; Delpre, George; Leiser, Alfredo; Neeman, Ami; Maoz, Eran; Anikin, Victor; Niv, Yaron
September 1998
American Journal of Gastroenterology;Sep1998, Vol. 93 Issue 9, p1478
Academic Journal
Objectives: Adequate preparation of the bowel is essential for accurate colonoscopic examination. We compared colonic preparation with sodium picosulphate plus magnesium citrate (SPS-Mg) with sulphate-free polyethylene glycol electrolyte lavage (PEG-EL) solution before colonoscopy, for quality of bowel cleansing, patient discomfort, and side effects. Methods: Sixty-eight consecutive patients were randomly assigned to receive either 3 sachets of SPS-Mg (16.5 g each) (n = 39) or 3 L of PEG-EL (n = 29) on the day before colonoscopy. Shortly before the procedure each patient was interviewed to determine the degree of discomfort (1 = none or mild, 2 = moderate, 3 = severe) and side effects. The quality of bowel cleansing was graded by a gastroenterologist who was unaware of the method of preparation (from 1 = poor to 4 = excellent). Results: Of the 29 PEG-EL patients, four (14%) did not complete the preparation because of side effects. The degree of discomfort was significantly greater with PEG-EL (mean score, 2.3 ± 0.7) than with SPS-Mg (mean score, 1.4 ± 0.5;p < 0.01). Nausea and vomiting were significantly more common in the PEG-EL group (38%vs 13%; p < 0.05). Using intention-to-treat analysis, bowel cleansing proved to be significantly better with SPS-Mg than with PEG-EL (mean score ± SD, 3.05 ± 0.9 and 2.57 ± 1.0, respectively; p = 0.036). Conclusions: Colonic preparation with SPS-Mg is better tolerated, associated with significantly fewer side effects, and results in higher quality bowel cleansing than preparation with PEG-EL.


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