TITLE

Pico-Salax Plus Two-Day Bisacodyl Is Superior to Pico-Salax Alone or Oral Sodium Phosphate for Colon Cleansing Before Colonoscopy

AUTHOR(S)
Hookey, Lawrence C.; Vanner, Stephen J.
PUB. DATE
March 2009
SOURCE
American Journal of Gastroenterology;Mar2009, Vol. 104 Issue 3, p703
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES:This study examined whether Pico-Salax alone or Pico-Salax plus bisacodyl tablets for two nights before colonoscopy afford superior efficacy, patient tolerance, and safety compared with oral sodium phosphate.METHODS:Patients undergoing outpatient colonoscopy were randomized to receive either Pico-Salax at 5 and 10 PM the night before colonoscopy plus bisacodyl 10 mg at 5 PM in the two earlier evenings (n=105), Pico-Salax alone at 5 and 10 PM the night before colonoscopy (n=109), or oral sodium phosphate at 5 and 10 PM the night (n=101) before colonoscopy. All groups were encouraged to drink 3–4 l of Gatorade or other clear fluids the night before the colonoscopy.RESULTS:Global scoring of cleansing efficacy using the Ottawa scale did not reveal differences among groups, but Pico-Salax plus bisacodyl was superior in cleansing the right colon compared with the other regimens (P=0.003), providing almost 50% improvement over oral sodium phosphate. Patient tolerance of Pico-Salax plus bisacodyl did not differ from Pico-Salax alone but was much better than oral sodium phosphate (P<0.0001). Hemodynamic and biochemical monitoring of patients on Pico-Salax plus bisacodyl suggests this regimen has a very strong safety profile. It does not differ from Pico-Salax alone, which lacks the hyperphosphatemia and hypocalcemia associated with oral sodium phosphate.CONCLUSIONS:Together, these data suggest that Pico-Salax plus bisacodyl provides enhanced colon cleansing in the right colon compared with Pico-Salax alone or oral sodium phosphate, but this finding does not compromise the much greater tolerability or the safety profile of Pico-Salax alone.Am J Gastroenterol 2009; 104: 703–709; doi:10.1038/ajg.2008.167; published online 17 February 2009
ACCESSION #
36803388

 

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