| Title: |
Split-dose bowel cleansing with picosulphate is safe and better tolerated than 2-l polyethylene glycol solution |
| Authors: |
Mathus-Vliegen, Elisabeth M.H.; van der Vliet, Karin; Wignand-van der Storm, Inge J.; Stadwijk, John S. |
| Source: |
European Journal of Gastroenterology & Hepatology ; volume 30, issue 7, page 709-717 ; ISSN 0954-691X |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2018 |
| Description: |
Background In physically less fit patients and patients requiring repeated exams, adequate bowel preparation for colonoscopy remains problematic, particularly because patients need to drink large volumes of unpleasant-tasting fluids. A further concern is potential unwarranted fluid shifts. Aims This study aimed to compare the safety and burden of a small-volume sodium picosulphate/magnesium citrate preparation (SPS-MC) with a 2-l ascorbic-acid-enriched polyethylene glycol solution plus bisacodyl pretreatment (PEG-Asc+B). Patients and methods Patients referred for colonoscopy were randomized to SPS-MC or PEG-Asc+B administered as a split-dose regimen. Patients received advice on the recommended 4-l SPS-MC and 2-l PEG-Asc+B fluid intake. Safety was assessed by blood sampling before and after the preparation and during a 30-day follow-up period. A questionnaire assessed tolerability and perceived burden of the preparation. Results A total of 341 patients underwent colonoscopy. Blood sampling showed a slight but significant decrease in sodium, chloride and osmolality and increase in magnesium in the SPS-MC group and a decrease in bicarbonate in the PEG-Asc+B group. Hyponatraemia and hypermagnesaemia without clinical signs were observed in 16 (14 SPS-MC) and 13 SPS-MC patients, respectively. Patients reported significantly fewer physical complaints and a significantly higher completion rate with SPS-MC. Patients receiving SPS-MC rated the intake as being easier and better tasting. In the event of a repeat colonoscopy, 59.7% of patients in the PEG-Asc+B and 93.6% of patients in the SPS-MC group would opt for the same preparation again. Conclusion Despite electrolyte shifts, both SPS-MC and PEG-Asc+B appeared clinically safe. From a patient’s perspective, a small-volume preparation formula such as SPS-MC is preferred, resulting in fewer physical complaints and greater ease of intake. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1097/meg.0000000000001120 |
| Availability: |
https://doi.org/10.1097/meg.0000000000001120; https://journals.lww.com/00042737-201807000-00004 |
| Accession Number: |
edsbas.CDE49C15 |
| Database: |
BASE |