A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation.
BACKGROUND:Colonoscopy remains the gold standard for the investigation of abnormalities within the colon. However, its success is highly dependent on the quality of bowel preparation. The objective of this study was to compare the bowel preparation efficacy of picosulfate/magnesium citrate (PMC) vs...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2019-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0211136 |
| _version_ | 1818938834294931456 |
|---|---|
| author | Alaa Rostom Catherine Dube Kirles Bishay Lilia Antonova Steven J Heitman Robert Hilsden |
| author_facet | Alaa Rostom Catherine Dube Kirles Bishay Lilia Antonova Steven J Heitman Robert Hilsden |
| author_sort | Alaa Rostom |
| collection | DOAJ |
| description | BACKGROUND:Colonoscopy remains the gold standard for the investigation of abnormalities within the colon. However, its success is highly dependent on the quality of bowel preparation. The objective of this study was to compare the bowel preparation efficacy of picosulfate/magnesium citrate (PMC) vs polyethylene glycol (PEG) in a one-day vs two-day split dose regimen. METHODS:A prospective, randomized, controlled trial was conducted at the Forzani & MacPhail Colon Cancer Screening Centre in Calgary, Canada. 171 colonoscopy outpatients were randomized to split-dose PMC or PEG lavage as well as into one-day split or two-day split regimens in blocks of eight. Bowel preparation quality was recorded in a blinded manner by the endoscopist using the Ottawa Bowel Preparation Scale (OBPS) prior to washing or suctioning. The scale results were analyzed using a two-factor analysis of variance. RESULTS:141 patients received complete colonoscopies (PMC-71; PEG-70). PEG was found to be superior to PMC (mean OBPS: 4.14 ± 2.64 vs 5.11 ± 3.44, p = 0.019), when adjusted for administration regimen, leading to significantly more adequate bowel preparations (79.7% vs 59.7%, p = 0.007). A two-day split dose was superior to a one-day split dose regimen (mean OBPS: 3.68± 2.82 vs 5.69 ± 3.06, p<0.001). Two-day split dosing also resulted in a better right colon cleanliness score (right bowel OBPS 1.27±0.11 vs 2.10±0.12 for one-day split, P<0.001). CONCLUSIONS:Optimal bowel preparation was achieved with the use of PEG lavage when administered in a two-day split dose regimen. This trial is registered with ClinicalTrials.gov under identifier NCT01415687. |
| first_indexed | 2024-12-20T06:14:09Z |
| format | Article |
| id | doaj.art-ac4b7b1b2bab48328a427ddb71928f41 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T06:14:09Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ac4b7b1b2bab48328a427ddb71928f412022-12-21T19:50:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01143e021113610.1371/journal.pone.0211136A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation.Alaa RostomCatherine DubeKirles BishayLilia AntonovaSteven J HeitmanRobert HilsdenBACKGROUND:Colonoscopy remains the gold standard for the investigation of abnormalities within the colon. However, its success is highly dependent on the quality of bowel preparation. The objective of this study was to compare the bowel preparation efficacy of picosulfate/magnesium citrate (PMC) vs polyethylene glycol (PEG) in a one-day vs two-day split dose regimen. METHODS:A prospective, randomized, controlled trial was conducted at the Forzani & MacPhail Colon Cancer Screening Centre in Calgary, Canada. 171 colonoscopy outpatients were randomized to split-dose PMC or PEG lavage as well as into one-day split or two-day split regimens in blocks of eight. Bowel preparation quality was recorded in a blinded manner by the endoscopist using the Ottawa Bowel Preparation Scale (OBPS) prior to washing or suctioning. The scale results were analyzed using a two-factor analysis of variance. RESULTS:141 patients received complete colonoscopies (PMC-71; PEG-70). PEG was found to be superior to PMC (mean OBPS: 4.14 ± 2.64 vs 5.11 ± 3.44, p = 0.019), when adjusted for administration regimen, leading to significantly more adequate bowel preparations (79.7% vs 59.7%, p = 0.007). A two-day split dose was superior to a one-day split dose regimen (mean OBPS: 3.68± 2.82 vs 5.69 ± 3.06, p<0.001). Two-day split dosing also resulted in a better right colon cleanliness score (right bowel OBPS 1.27±0.11 vs 2.10±0.12 for one-day split, P<0.001). CONCLUSIONS:Optimal bowel preparation was achieved with the use of PEG lavage when administered in a two-day split dose regimen. This trial is registered with ClinicalTrials.gov under identifier NCT01415687.https://doi.org/10.1371/journal.pone.0211136 |
| spellingShingle | Alaa Rostom Catherine Dube Kirles Bishay Lilia Antonova Steven J Heitman Robert Hilsden A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation. PLoS ONE |
| title | A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation. |
| title_full | A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation. |
| title_fullStr | A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation. |
| title_full_unstemmed | A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation. |
| title_short | A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation. |
| title_sort | randomized clinical prospective trial comparing split dose picosulfate magnesium citrate and polyethylene glycol for colonoscopy preparation |
| url | https://doi.org/10.1371/journal.pone.0211136 |
| work_keys_str_mv | AT alaarostom arandomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT catherinedube arandomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT kirlesbishay arandomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT liliaantonova arandomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT stevenjheitman arandomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT roberthilsden arandomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT alaarostom randomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT catherinedube randomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT kirlesbishay randomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT liliaantonova randomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT stevenjheitman randomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation AT roberthilsden randomizedclinicalprospectivetrialcomparingsplitdosepicosulfatemagnesiumcitrateandpolyethyleneglycolforcolonoscopypreparation |