Comparison Between Same-Day and Split-Dose Preparations with Sodium Picosulfate/Magnesium Citrate: A Randomized Noninferiority Study

Dig Dis Sci. 2022 Aug;67(8):3964-3975. doi: 10.1007/s10620-021-07265-y. Epub 2021 Oct 17.

Abstract

Background: Sodium picosulfate/magnesium citrate (SPMC) is a small-volume bowel cleansing agent with similar efficacy to and better tolerability than polyethylene glycol. However, we found no data on which SPMC preparation (same-day vs. split-dose) provides better bowel cleansing efficacy for afternoon colonoscopy.

Aims: To compare bowel cleansing efficacy of different timing of the regimen.

Methods: This randomized, single-center, endoscopist-blinded, noninferior study compared same-day and split-dose SPMC preparations for afternoon colonoscopy in 101 and 96 patients, respectively. We also included a prospective observation group of 100 patients receiving morning colonoscopy to compare bowel preparation between morning and afternoon colonoscopies. Bowel cleansing efficacy was then evaluated by the Aronchick Scale, Ottawa Bowel Preparation Scale (OBPS), Boston Bowel Preparation Scale (BBPS), and the Bubble Scale.

Results: Same-day and split-dose preparations were similar in efficacy in all four scales. In the Aronchick Scale, the success rate (excellent and good cleanliness) was higher in same-day preparation than in split-dose preparation (100% vs. 92.8%). The same-day preparation also obtained a better OBPS score (1.4 vs. 2.1), but BBPS showed no difference between such groups (7.7 vs. 7.4).

Conclusion: Same-day preparation with SPMC is not inferior to split-dose preparation for afternoon colonoscopy.

Keywords: Bowel preparation; Colonoscopy; Comparison; Complication; Quality; Sodium picosulfate.

Publication types

  • Equivalence Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cathartics* / adverse effects
  • Citrates / adverse effects
  • Citric Acid
  • Colonoscopy
  • Humans
  • Organometallic Compounds* / adverse effects
  • Picolines / adverse effects
  • Polyethylene Glycols
  • Prospective Studies

Substances

  • Cathartics
  • Citrates
  • Organometallic Compounds
  • Picolines
  • Citric Acid
  • Polyethylene Glycols
  • picosulfate sodium
  • magnesium citrate