MiraLAX-Gatorade bowel prep versus GoLytely before screening colonoscopy: an endoscopic database study in a community hospital

J Clin Gastroenterol. Nov-Dec 2012;46(10):e96-e100. doi: 10.1097/MCG.0b013e3182617bfb.

Abstract

Background: Polyethylene glycol-3350 without electrolytes (MiraLAX; Schering-Plough Healthcare Products Inc.)+a carbohydrate-electrolyte solution (Gatorade; PepsiCo Inc.)+bisacodyl is frequently used for bowel cleansing, although limited data quantifies its efficacy and safety. No prior studies have assessed this in a community setting or with PM-only dosing, which is still used frequently.

Aim: To compare the frequency of excellent/good/fair/poor bowel cleansing with PM-only dosing of MiraLAX-Gatorade-bisacodyl versus 4-liter GoLytely.

Methods: This is a retrospective endoscopic database analysis of 50 years and older average-risk individuals with a normal screening colonoscopy at a community hospital and ambulatory endoscopy center. Data were extracted for the last 4 months when 4-liter GoLytely was the preferred bowel purgative and the first 4 months when 238-g MiraLAX in 64-ounce Gatorade and four 5-mg bisacodyl tablets became the preferred purgative. All patients used PM-only dosing of bowel purgative.

Results: A total of 778 subjects [GoLytely (n=395) vs. MiraLAX+Gatorade+bisacodyl (n=383)] were identified. Patients who took the MiraLAX bowel preparation were more likely to achieve an excellent/good bowel cleansing compared with patients taking the GoLytely preparation (93.3% vs. 89.3%, respectively; P=0.048). However, when only American Society of Anesthesiology (ASA) class I patients are studied, there was no difference in frequency of excellent/good bowel cleansing (91.1% vs 93.6%, respectively; P=0.498). No serious adverse events were identified. An excellent/good bowel cleansing was strongly associated with a recommendation for repeat colonoscopy in 10 years compared with patients with a fair cleansing (odds ratio=28.01; 95% confidence interval, 13.96-56.19).

Conclusions: The MiraLAX+Gatorade+bisacodyl combination produces similar rates of excellent/good bowel cleansing as compared with GoLytely in most average-risk individuals undergoing colonoscopy for colorectal screening in a community setting.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Bisacodyl / administration & dosage
  • Cathartics / administration & dosage*
  • Colonoscopy / methods*
  • Colonoscopy / standards
  • Confidence Intervals
  • Early Detection of Cancer / methods
  • Electrolytes / administration & dosage*
  • Female
  • Hospitals, Community
  • Humans
  • Isotonic Solutions / administration & dosage*
  • Male
  • Middle Aged
  • Odds Ratio
  • Polyethylene Glycols / administration & dosage*
  • Retrospective Studies

Substances

  • Cathartics
  • Electrolytes
  • Golytely
  • Isotonic Solutions
  • gatorade
  • Bisacodyl
  • Polyethylene Glycols