A Single or Split Dose Picosulphate/Magnesium Citrate Before Colonoscopy: Comparison Regarding Tolerance and Efficacy with Polyethylene Glycol. A Randomized Trial

KOJECKY, Vladimir, Jiří DOLINA, Bohuslav KIANIČKA, Miroslav MISUREC, Michal VARGA, Jiri LATTA and Vladimir VACULIN. A Single or Split Dose Picosulphate/Magnesium Citrate Before Colonoscopy: Comparison Regarding Tolerance and Efficacy with Polyethylene Glycol. A Randomized Trial. Journal of Gastrointestinal and Liver Diseases. CLUJ-NAPOCA: MEDICAL UNIV PRESS, 2014, vol. 23, No 2, p. 141-146. ISSN 1841-8724.

Basic information

• Original name: A Single or Split Dose Picosulphate/Magnesium Citrate Before Colonoscopy: Comparison Regarding Tolerance and Efficacy with Polyethylene Glycol. A Randomized Trial
• Authors: KOJECKY, Vladimir (203 Czech Republic), Jiří DOLINA (203 Czech Republic, guarantor, belonging to the institution), Bohuslav KIANIČKA (203 Czech Republic, belonging to the institution), Miroslav MISUREC (203 Czech Republic), Michal VARGA (203 Czech Republic), Jiri LATTA (203 Czech Republic) and Vladimir VACULIN (203 Czech Republic).
• Edition: Journal of Gastrointestinal and Liver Diseases, CLUJ-NAPOCA, MEDICAL UNIV PRESS, 2014, 1841-8724.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30200 3.2 Clinical medicine
• Country of publisher: Romania
• Confidentiality degree: is not subject to a state or trade secret
• Impact factor: Impact factor: 2.202
• RIV identification code: RIV/00216224:14110/14:00076236
• Organization unit: Faculty of Medicine
• UT WoS: 000337333300007
• Keywords in English: colonoscopy; bowel preparation; sodium picosulphate; polyethylene glycol
• Tags: EL OK
• Tags: International impact, Reviewed

Abstract

To compare the efficacy and tolerance of sodium picosulphate/magnesium citrate (PMC) and polyethylene glycol (PEG) in a single or split dose regimen for colonoscopy bowel preparation. Methods: A prospective, randomized, endoscopist-blinded, multicenter study. The patients were randomly assigned to receive PMC (PMC4/0) or PEG (PEG4/0) in a single dose 4L day before colonoscopy or a split dose 2+2L PMC (PMC2/2) or 3+1L PEG (PEG3/1) one day before and in the morning before the colonoscopy. Each patient was interviewed to determine his/her subjective tolerance of the preparation before the procedure. The quality of bowel cleansing was assessed in a blinded test performed by multiple endoscopists using the Aronchick scale. Results: A total of 600 patients were enrolled, 88.2% were included in the analysis. Satisfactory bowel cleansing (Aronchick score 1 and 2) was significantly more frequent when a split dose was used irrespective of the solution type (81.6% PMC2/2, 87.3% PEG3/1 vs. 73.0% PEG4/0, p = 0.024). In single dose regimens, PMC performed better than PEG (82.6% vs. 73.0%). Single or split dose PMC preparations were comparable. A PMC based solution was generally better tolerated than PEG regardless of the regimen used (p <0.001). Nausea was reported mostly after the 4L PEG (32.8%, p < 0.001), incontinence after a split PMC dose (34.4%, p = 0.002), and bloating after the 4L PEG (38.0%, p < 0.001). There was no significant difference in the prevalence of vomiting. Conclusion: Colonic preparation with PMC yields similar results as a split PEG dose, regardless of whether PMC is administered in single or separate doses. PMC is better tolerated than any PEG-based preparation. A single 4L PEG the day before the colonoscopy is less appropriate for bowel cleansing.