A STUDY OF A NEW OSMOTIC PURGATIVE FOR COLONOSCOPY - IS GOLYTELY(R) WORTH ITS SALT

An osmotic laxative containing polyethylene glycol. and sodium sulfate (Golytely(R) Braintree Laboratories, Inc,, Braintree, MA) is widely u sed to clean the colon for colonoscopy. However, its salty taste makes the mixture unpalatable. We therefore tested the claim that a similar solution but without sodium sulfate (Golytely-RSS(R) Braintree Labora tories, Inc., Braintree, MA) makes preparation of the colon more accep table to patients in a double-blinded randomized controlled trial. Col onic preparation using polyethylene glycol with or without sodium sulf ate was randomized in 100 patients due to undergo colonoscopy. The ove rall acceptability of the regimen was measured on a linear analogue sc ale and an estimate of symptoms was obtained. Body weight and serum el ectrolytes, urea, creatinine, hemoglobin and hematocrit were determine d before and after preparation in order to assess fluid absorption. Th e efficacy of colonic cleansing was graded by the colonoscopist. Four patients did not complete the protocol, 47 received the regimen contai ning sodium sulfate and 49 received the regimen without it. The two gr oups did not differ in age or body mass. There was no statistical diff erence in the overall acceptability of the two regimens to the patient s (median acceptability rating 74 for regimen with sodium sulfate, ran ge 4-100 compared with 77 for regimen without, range 3-100, p = 0.32, Mann-Whitney test). Nor was there any difference in taste, nausea, vom iting, cramping or perianal discomfort or in the endoscopists' rating of the cleanliness of the colon. The serum sodium concentration rose s lightly (mean 1.6 mmol/L) when the regimen with sodium sulfate was use d. Moreover, prescribing the laxative regimen without sodium sulfate i ncreased the cost of the regimen by 65 percent. In preparing the colon for colonoscopy, omitting sodium sulfate from the conventional mixtur e of polyethylene glycol and sodium sulfate does not make the preparat ion more acceptable to patients, does not affect the cleanliness of th e colon and increases the cost of the laxative substantially. Golytely (R) is therefore preferable to Golytely-RSS(R).