Polyethylene glycol plus ascorbic acid is as effective as sodium picosulfate with magnesium citrate for bowel preparation : randomized trial

ABSTRACT

Background and Aim

Optimal colon cleansing is essential for the efficacy and safety of endoscopic evaluation of the colon. However, consumption of large volumes of bowel preparation agent, along with its bad taste and potential adverse effects often prevent patients from receiving an ideal colonoscopy. We evaluated the efficacy and safety of two low- volume agents for bowel preparation.

Methods

We performed a prospective, endoscopist-blinded, single-center, randomized controlled trial comparing PEG-3350 plus ascorbic acid (PEG + Asc, Coolprep) in a 10-mg bisacodyl tablet versus sodium picosulfate with magnesium citrate (SPMC, Picolight) in a 10-mg bisacodyl tablet. The primary objective was to evaluate the bowel cleansing effect of the two regimens using the modified Ottawa scale and the Aronchick scale. Patient overall tolerability were assessed with a questionnaire.

Results

In total, 200 patients were randomized to receive either PEG + Asc (n = 98) or SPMC (n = 102). Both groups showed similar efficacy in bowel cleansing, based on the modified Ottawa (PEG + Asc 4.01 ± 2.29 vs. SPMC 3.86 ± 2.47; p = 0.62) and Aronchick scales (PEG + Asc 1.96 ± 0.70 vs. SPMC 1.89 ± 0.70; p = 0.42). Patient-reported taste and tolerability for each regimen, examined on the questionnaire, were significantly greater for the PEG + Asc group than the SPMC group (P < 0.0001). Adverse events, such as headache and dizziness, were higher in the PEG + Asc group (p = 0.08 and 0.03, respectively). However, nausea was more common in the SPMC group (p = 0.02).

Conclusions

Both regimens showed similar bowel preparation efficacy. However, patient overall tolerability was higher in the PEG + Asc group.

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