Efficacy and tolerability of sodium picosulphate with magnesium citrate versus polyethylene glycol electrolyte lavage solution for colouoscopy preparation

We compared a colonic preparation with sodium picosulphate and magnesium citrate (SPS-Mg) to a polyethylene glycol electrolyte lavage (PEG-EL) solution for quality of bowel cleansing, patient discomfort and side effects. Methods: Sixty-eight consecutive patients were randomly assigned to preparation with 3 sachets of SPS-Mg (16.5 gr each) (n=39) or 3 liters of PEG-EL (n=29) on the day before colonoscopy. Shortly before the procedure, each patient was interviewed to determine the degree of discomfort (from 1 = none or mild to 4 = excellent), and the extent of colonoscopy was noted. Results: The 2 groups were similar in patient age, gender and origin, and indication for colonoscopy. Of the 29 PEG-EL patients, 4 (14%) did not complete the preparation because of side effects (nausea, vomiting and palpitations). The degree of discomfort was significantly greater with PEG-EL (mean score 2.3±0.7) than with SPS-Mg (mean score, 1.4±0.5) (P<0.01). Side effects were significantly more common in the PEG-EL group (41% vs. 26%, P<0.01). Using intention-to-treat analysis, bowel cleansing proved to be significantly better with SPS-Mg than with PEG-EL (mean scores±SD, 3.05±0.9 and 2.57±1.0, respectively, P<0.05). No significant difference was noted in the extent of colonoscopy between the 2 groups (the cecum was reached in 90% of the patients in both). Conclusions: Colonic preparation with SPS-Mg is better tolerated, associated with significantly fewer side effects and results in higher quality bowel cleansing than preparation with PEG-EL.