A randomised controlled trial of a new 2 litre polyethylene glycol solution versus sodium picosulphate + magnesium citrate solution for bowel cleansing prior to colonoscopy^*

ABSTRACT

Background: A new 2 L polyethylene glycol (PEG) solution containing ascorbic acid (Asc) and electrolytes (Moviprep^†) has been developed for bowel cleansing.

Objectives: To compare the efficacy, safety and acceptability of PEG + Asc versus sodium picosulphate + magnesium citrate in patients scheduled to undergo colonoscopy.

Design and methods: This single blind, parallel group pilot study included 65 adult male and female patients. A blinded assessment of cleansing was made for each bowel segment by the colonoscopist and the scores determined an overall grading of bowel cleansing. Patients completed a questionnaire on the acceptability of the preparation.

Results: Successful bowel preparation was reported in 84.4% of patients who received PEG + Asc and 72.7% of patients who received sodium picosulphate + magnesium citrate (treatment difference +11.6, 95% CI –11.2, +34.5; p = 0.367). Patients were more likely to have a higher overall quality of bowel cleansing with PEG + Asc ( p = 0.018), with specifically better cleansing in the ascending colon ( p = 0.024) and caecum ( p = 0.003) compared with patients who received sodium picosulphate + magnesium citrate. The adverse event profile of the two treatments was similar, with headache and gastrointestinal effects being the most commonly reported. Some patient acceptability results favoured sodium picosulphate + magnesium citrate for those patients who had experience of previous bowel preparation, but were similar for those patients who had not had a previous bowel preparation.

Conclusions: PEG + Asc provided effective bowel cleansing, which was equivalent to that of sodium picosulphate + magnesium citrate in terms of grading cleansing as overall success or failure. In the proximal colon (ascending colon and caecum) PEG + Asc provided significantly better cleansing to that achieved with sodium picosulphate + magnesium citrate.

Trial registration: ClinicalTrials.gov identifier: NCT00312481.

Key words: :

• Bowel preparation
• Colonoscopy
• Macrogol
• Magnesium citrate
• Polyethylene glycol
• Sodium picosulphate