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Am J Gastroenterol. 2009 Mar;104(3):703-9. doi: 10.1038/ajg.2008.167. Epub 2009 Feb 17.

Pico-salax plus two-day bisacodyl is superior to pico-salax alone or oral sodium phosphate for colon cleansing before colonoscopy.

Author information

1
Department of Medicine, Queen's University, Kingston, Ontario, Canada. lawrencehookey@yahoo.ca

Abstract

OBJECTIVES:

This study examined whether Pico-Salax alone or Pico-Salax plus bisacodyl tablets for two nights before colonoscopy afford superior efficacy, patient tolerance, and safety compared with oral sodium phosphate.

METHODS:

Patients undergoing outpatient colonoscopy were randomized to receive either Pico-Salax at 5 and 10 PM the night before colonoscopy plus bisacodyl 10 mg at 5 PM in the two earlier evenings (n=105), Pico-Salax alone at 5 and 10 PM the night before colonoscopy (n=109), or oral sodium phosphate at 5 and 10 PM the night (n=101) before colonoscopy. All groups were encouraged to drink 3-4 l of Gatorade or other clear fluids the night before the colonoscopy.

RESULTS:

Global scoring of cleansing efficacy using the Ottawa scale did not reveal differences among groups, but Pico-Salax plus bisacodyl was superior in cleansing the right colon compared with the other regimens (P=0.003), providing almost 50% improvement over oral sodium phosphate. Patient tolerance of Pico-Salax plus bisacodyl did not differ from Pico-Salax alone but was much better than oral sodium phosphate (P<0.0001). Hemodynamic and biochemical monitoring of patients on Pico-Salax plus bisacodyl suggests this regimen has a very strong safety profile. It does not differ from Pico-Salax alone, which lacks the hyperphosphatemia and hypocalcemia associated with oral sodium phosphate.

CONCLUSIONS:

Together, these data suggest that Pico-Salax plus bisacodyl provides enhanced colon cleansing in the right colon compared with Pico-Salax alone or oral sodium phosphate, but this finding does not compromise the much greater tolerability or the safety profile of Pico-Salax alone.

PMID:
19223885
DOI:
10.1038/ajg.2008.167
[Indexed for MEDLINE]

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