COMPARISON OF 2 BOWEL PREPARATIONS FOR COLONOSCOPY - SODIUM PICOSULPHATE WITH MAGNESIUM CITRATE VERSUS SULFATE-FREE POLYETHYLENE-GLYCOL LAVAGE SOLUTION

Objectives: Adequate preparation of the bowel is essential for accurat e colonoscopic examination. We compared colonic preparation with sodiu m picosulphate plus magnesium citrate (SPS-Mg) with sulphate-free poly ethylene glycol electrolyte lavage (PEG-EL) solution before colonoscop y, for quality of bowel cleansing, patient discomfort, and side effect s. Methods: Sixty-eight consecutive patients were randomly assigned to receive either 3 sachets of SPS-Mg (16.5 g each) (n = 39) or 3 L of P EG-EL (n = 29) on the day before colonoscopy. Shortly before the proce dure each patient was interviewed to determine the degree of discomfor t (1 = none or mild, 2 = moderate, 3 = severe) and side effects. The q uality of bowel cleansing was graded by a gastroenterologist who was u naware of the method of preparation (from 1 = poor to 4 = excellent). Results: Of the 29 PEG-EL patients, four (14%) did not complete the pr eparation because of side effects. The degree of discomfort was signif icantly greater with PEG-EL (mean score, 2.3 +/- 0.7) than with SPS-Mg (mean score, 1.4 +/- 0.5; p < 0.01). Nausea and vomiting were signifi cantly more common in the PEG-EL group (38% vs 13%; p < 0.05). Using i ntention-to-treat analysis, bowel cleansing proved to be significantly better with SPS-Mg than with PEG-EL (mean score +/- SD, 3.05 +/- 0.9 and 2.57 +/- 1.0, respectively; p = 0.036). Conclusions: Colonic prepa ration with SPS-Mg is better tolerated, associated with significantly fewer side effects, and results in higher quality bowel cleansing than preparation with PEG-EL. (Am J Gastroenterol 1998; 93:1478-1482. (C) 1998 by Am. Cell. of Gastroenterology).