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

2014 ◽  
Vol 23 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Vladimir Kojecky ◽  
Jiri Dolina ◽  
Bohuslav Kianicka ◽  
Miroslav Misurec ◽  
Michal Varga ◽  
...  
Keyword(s):  
Single Dose ◽  
Polyethylene Glycol ◽  
Magnesium Citrate ◽  
Split Dose ◽  
Sodium Picosulphate ◽  
Solution Type ◽  
Bowel Cleansing ◽  
Significant Difference ◽  
Colonic Preparation

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.

scholarly journals Preparation regimen is more important than patient-related factors: a randomized trial comparing a standard bowel preparation before colonoscopy with an individualized approach

2017 ◽  
Vol 55 (1) ◽  
pp. 36-43 ◽  
Author(s):  
T. Voiosu ◽  
Alina Tanţău ◽  
A. Voiosu ◽  
Andreea Benguş ◽  
Cristina Mocanu ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Multivariable Analysis ◽  
Standard Group ◽  
Related Factors ◽  
Split Dose ◽  
Bowel Cleansing ◽  
Significant Difference ◽  
Bowel Prep

Abstract Background. Optimal bowel preparation is one of the most important factors affecting the quality of colonoscopy. Several patient-related factors are known to influence the quality of bowel cleansing but randomized trials in this area are lacking. We aimed to compare an individualized bowel prep strategy based on patient characteristics to a standard preparation regimen. Material and Methods. We conducted an endoscopist-blinded multicenter randomized control-trial. The Boston Bowel Prep Score (BBPS) was used to assess quality of bowel preparation and a 10 point visual analogue scale to assess patient comfort during bowel prep. Patients were randomised to either the standard regimens of split-dose 4L polyethylene-glycol (group A), split-dose sodium picosulphate/magnesium citrate (group B) or to either of the two depending on their responses to a 3-item questionnaire (individualized preparation, group C). Results. 185 patients were randomized during the study period and 143 patients were included in the final analysis. Patients in the individualized group had a median BBPS of 7 compared to a median of 6 in the standard group (p = 0.7). Also, there was no significant difference in patients’ comfort scores, irrespective of study group or laxative regimen. However, on multivariable analysis, a split-dose 4L polyethylene-glycol was an independent predictor for achieving a BBPS>6 (OR 3.7, 95% CI 1.4-9.8), regardless of patient-related factors. Conclusion. The choice of laxative seems to be more important than patient-related factors in predicting bowel cleansing. Comfort during bowel prep is not influenced by the type of strategy used.

scholarly journals Effectiveness in Bowel Cleansing and Patient Tolerability of Polyethylene Glycol versus Sodium Picosulphate in Patients Undergoing Colonoscopy

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Amit Kumar Jaiswal ◽  
Shatdal Chaudhary
Keyword(s):  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Lesion Detection ◽  
Open Label ◽  
Split Dose ◽  
Sodium Picosulphate ◽  
Bowel Cleansing ◽  
Colonic Preparation ◽  
Sodium Picosulfate ◽  
Structured Questionnaire

Introduction. Colonoscopy is considered as a gold standard investigation for screening of colorectal cancer and other lower gastrointestinal pathologies. Adequate bowel preparation is absolutely necessary for a fruitful colonoscopy. Various bowel cleansing agents are being used for his purpose. The aim of the present study was to compare the two bowel cleansing agents: a single dose of Polyethylene Glycol (PEG) solution and a split dose of Sodium Picosulfate (Na PICOSUL) tablet with regards to cleansing efficacy and tolerability among the patients scheduled for colonoscopy. Methods. It is an open-label hospital-based observational study. A total of sixty-four patients were grouped randomly into two groups of bowel cleansing agents that are PEG and Na PICOSUL during the study period between 1st December 2015 and 30th November 2016. Patients’ tolerability was evaluated using a structured questionnaire, and the bowel cleansing efficacy was evaluated using the Aronchick Bowel Preparation Scale (ABPS). Results. The group that received PEG solution was found to have better efficacy than that which received Na PICOSUL tablet (63.3% versus 29.4%, respectively, with a P value < 0.028) with excellent grade as per ABPS. The Na PICOSUL group was found better in terms of tolerability than the PEG group as nausea/vomiting was encountered significantly higher in the PEG group than in the Na PICOSUL group (43.3% versus 11.8%, respectively, with a P value < 0.01). Conclusions. Colonic preparation with a split dose of Na PICOSUL tablet was better tolerated than the evening before regimen of PEG solution. However, PEG solution was found to be more efficacious in bowel cleansing, but procedural performance and lesion detection were similar for both agents.

scholarly journals Gastric Residual Volume after Split-Dose Bowel Preparation versus Conventional Single-Dose Regimen before Anesthetic Colonoscopy

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Shi-gui Xue ◽  
Han-lin Chen ◽  
Chun-sheng Cheng ◽  
Bao-sheng Huang ◽  
Hou-de Zhang
Keyword(s):  
Single Dose ◽  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Dose Group ◽  
Prospective Observational Study ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Split Dose ◽  
Bowel Cleansing ◽  
Risk Of Aspiration

The aim of this study was to compare gastric residual volume (GRV) in patients given a split-dose versus a conventional single-dose of polyethylene glycol (PEG) preparation before undergoing anesthetic colonoscopy. Methods. In a prospective observational study, we assessed GRV in outpatients undergoing same-day anesthetic gastroscopy and colonoscopy between October 8 and December 30 of 2016. Outpatients were assigned to the split-dose (1 L PEG in the prior evening and 1 L PEG 2–4 h before endoscopy) or single-dose (ingestion of 2 L PEG ≥ 6 h before endoscopy) regimen randomly. Bowel cleansing quality was assessed with the Boston Bowel Preparation Scale (BBPS). Results. The median GRV in the split-dose group (17 ml, with a range of 0–50 ml; N=65) was significantly lower than that in the single-dose group (22 ml, with a range of 0–62 ml; N=64; p=0.005), with a better bowel cleansing quality (BBPS score 8.05±0.82 versus 7.64±1.21; p=0.028). GRV was not associated with diabetes or the use of medications. Conclusions. GRV after a split-dose preparation and fasting for 2–4 hours is not larger than that after a conventional single-dose preparation and fasting for 6–8 hours. The data indicates that the split-dose bowel preparation might not increase the risk of aspiration.

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

2011 ◽  
Vol 25 (12) ◽  
pp. 663-666 ◽  
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.

Su1269 Split-Dose Sodium Picosulphate/Magnesium Citrate for Morning Colonoscopies Performed From 2 to 6 Hours After Fluids Intake: Efficacy, Safety and Acceptance Compared to Bowel Cleansing the Day Before

2012 ◽  
Vol 75 (4) ◽  
pp. AB273
Author(s):  
Javier Molina-Infante ◽  
Elisa Martin-Noguerol ◽  
Jesus M. Gonzalez-Santiago ◽  
Carmen Martinez-Alcala ◽  
Gema Vinagre Rodriguez ◽  
...  
Keyword(s):  
Magnesium Citrate ◽  
Split Dose ◽  
Sodium Picosulphate ◽  
Bowel Cleansing
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