THE QUEST FOR A MORE ACCEPTABLE BOWEL PREPARATION - COMPARISON OF A POLYETHYLENE GLYCOL ELECTROLYTE SOLUTION AND A MANNITOL/PICOLAX MIXTUREFOR COLONOSCOPY/

Eighty-nine consecutive patients attending for day-case colonoscopy we re randomly allocated either polyethylene glycol/balanced electrolyte (PEG) mixture (n = 45) or a mannitol/Picolax mixture (n = 44). Both pr eparations were administered in two fractions. Patients recorded their experience of the preparation on a questionnaire and one of two exper ienced endoscopists (unaware of the type of preparation given) assesse d the result of bowel cleansing. Carbon dioxide insufflation was used for all examinations. Good/excellent bowel cleansing occurred in signi ficantly more patients given PEG, 43 (96%), than those allocated manni tol/Picolax, 34 (77%), p = 0.01. More patients receiving mannitol/Pico lax were able to complete the preparation in full than patients receiv ing PEG (38 vs 27, p = 0.01). More patients found the taste of mannito l/Picolax pleasant compared to PEG (46% vs 20%). Both preparations had a similar side-effect profile. Of those patients tested, 13% receivin g mannitol/Picolax had a postural drop in blood pressure and blood par ameters suggestive of mild dehydration. A fractionated administration of PEG as a bowel preparation for day-case colonoscopy is well tolerat ed and superior as a cleansing agent to a mannitol/Picolax combination . Provided carbon dioxide is used as the insufflating agent, mannitol/ Picolax is an acceptable alternative in fit, young patients intolerant of PEG.