P.15.5 SPLIT DOSAGE AND OTHER PREDICTORS OF QUALITY OF BOWEL CLEANSING IN PATIENTS ASSUMING A “VERY LOW VOLUME” PREPARATION FOR COLONOSCOPY: AN ITALIAN MULTICENTER STUDY USING THE ASSOCIATION OF SODIUM PICOSULPHATE AND MAGNESIUM CITRATE

Background & Aims: To compare the eficacy 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 signicantly 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.

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Comparison of Two Common Outpatient Preparations for Colonoscopy in Children and Youth

Gastroenterology Research and Practice ◽

10.1155/2009/518932 ◽

2009 ◽

Vol 2009 ◽

pp. 1-4 ◽

Cited By ~ 12

Author(s):

Carolina Jimenez-Rivera ◽

Donna Haas ◽

Margaret Boland ◽

Janice L. Barkey ◽

David R. Mack

Keyword(s):

Citric Acid ◽

Bowel Preparation ◽

Outpatient Clinic ◽

Chart Review ◽

Retrospective Chart Review ◽

Children And Youth ◽

Magnesium Citrate ◽

Sodium Picosulphate ◽

Bowel Cleansing ◽

Gastroenterology Outpatient Clinic

Colonoscopies are often performed in children for diagnostic and therapeutic purposes. Our study compared two bowel-cleansing solutions: sodium picosulphate, magnesium oxide, and citric acid (Pico-Salax) with liquid magnesium citrate as preparations for colonoscopy. A retrospective chart review of all patients seen in the Gastroenterology outpatient clinic and who underwent bowel cleansing in preparation for colonoscopy from February to December 2006 was undertaken. Thirty-two children received Pico-Salax and 36 received liquid magnesium citrate. The tolerability of both solutions was similar. Most children in both groups had liquid stools and complete colonoscopies. Bowel preparation for a colonoscopy can be successfully achieved using either Pico-Salax or liquid magnesium citrate.

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Timing and Frequency of Bowel Activity in Patients Ingesting Sodium Picosulphate/Magnesium Citrate and Adjuvant Bisacodyl for Colon Cleansing Before Colonoscopy

Canadian Journal of Gastroenterology ◽

10.1155/2011/950263 ◽

2011 ◽

Vol 25 (12) ◽

pp. 663-666 ◽

Cited By ~ 7

Author(s):

Stephen Vanner ◽

Lawrence C Hookey

Keyword(s):

Bowel Preparation ◽

Bowel Movement ◽

Magnesium Citrate ◽

Split Dose ◽

Colon Cleansing ◽

Sodium Picosulphate ◽

Bowel Cleansing ◽

Bowel Movements ◽

Bowel Movement Frequency ◽

The Mean

BACKGROUND: Despite the wealth of research investigating bowel cleansing efficacy, there are very little data on the timing or frequency of bowel movements after each agent is ingested.OBJECTIVE: To examine the effect of each component of a three-day combined sodium picosulphate/magnesium citrate (PSLX) and bisacodyl regimen on the timing and frequency of bowel activity in patients undergoing colonoscopy.METHODS: Outpatients booked for colonoscopy were asked to complete a diary of their bowel preparation that tracked the timing of bowel movements. Bowel preparation quality was assessed using the Ottawa Bowel Preparation Scale. Bowel activity was compared with baseline and correlated with colon cleansing. Subgroup analysis was performed examining the effect of timing of the procedure and split-dose regimens.RESULTS: One hundred patients undergoing colon cleansing received bisacodyl 10 mg at 17:00 three days and two days before the day of colonoscopy. In one group, both sachets of PSLX were given the night before colonoscopy, while the second group, whose colonoscopies were scheduled after 11:00, ingested one sachet the night before and the second sachet at 06:00 on the day of colonoscopy. Patients had a mean of 1.7 bowel movements per day in the seven days before starting the cleansing regimen. Both doses of bisacodyl tablets resulted in a significant increase in the mean number of bowel movements compared with baseline (3.3/day first dose; 3.8/day second dose [P=0.03 and 0.001, respectively]). Each dose of PSLX also resulted in a significant increase in bowel movement frequency compared with baseline, with means of 4.4, 6.3 and 4.5 bowel movements after each dose. The mean time to the final bowel movement following the second sachet of PSLX was 8.9 h when taken the night before, and 3.9 h when taken the morning of the procedure. Bowel preparation quality significantly correlated with bowel frequency when total bowel movements were considered and when only the effects of bisacodyl were accounted for (P<0.01 for each).DISCUSSION: These data demonstrate that the addition of bisacodyl before PSLX ingestion has a significant additive effect on bowel frequency and correlates with bowel cleansing quality. The timing of the resulting bowel movements have practical implications for sleep and travel times to endoscopy suites.

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