Original articleClinical endoscopySplit-dose picosulfate, magnesium oxide, and citric acid solution markedly enhances colon cleansing before colonoscopy: a randomized, controlled trial
Section snippets
Study design, patient population, and randomization
This was a prospective, randomized study, and the endoscopists were blinded to the dosing regimen. All patients ≥18 years of age undergoing elective outpatient colonoscopy at the Hotel Dieu Hospital in Kingston, Ontario, Canada, were invited to participate in the study. Exclusion criteria included ileus or bowel obstruction, significant constipation (<3 bowel movements per week with or without regular laxatives), previous colorectal surgery, ascites, previously recognized renal impairment
Results
A total of 250 patients were enrolled in the study between October 2008 and March 2010. Fourteen patients were randomized but never participated (6 in the traditional arm, 8 in the split-dose arm) because the target numbers had been reached. An additional 14 patients (8 in the traditional arm, 6 in the split-dose arm) did not have a completed OBPS data sheet available: 9 because of incomplete colonoscopies attributed to technical difficulties (5 in the traditional arm, 4 in the split-dose arm),
Discussion
Previous studies have shown that PSLx is a very effective preparation compared with other existing colon cleansing regimens,9, 23 but enhanced efficacy remains a goal with all preparations. The results of this study show that the split-dose PSLx regimen results in superior overall bowel cleansing compared with the traditional dosing schedule (ie, both doses given the evening before). The magnitude of this difference was substantial given that the absolute difference by using the OBPS was 1.46.
Acknowledgments
The authors thank Natasha Jackson, Jackie McKay, Darlene Brady, and the Hotel Dieu Hospital in Kingston, Ontario, for their support during the study.
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Drugs
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DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: Drs. Hookey and Vanner are consultants to and educational grant recipients from Ferring Canada and Ferring USA. The other author disclosed no financial relationship relevant to this publication.