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Multicenter Study
. 2009 Oct;23(10):706-10.
doi: 10.1155/2009/385619.

A multicentre, observational study of sodium picosulfate and magnesium citrate as a precolonoscopy bowel preparation

Jonthan Love  1 , Edmond-Jean Bernard, Alan Cockeram, Lawrence Cohen, Martin Fishman, James Gray, David Morgan
Affiliations
Multicenter Study

A multicentre, observational study of sodium picosulfate and magnesium citrate as a precolonoscopy bowel preparation

Jonthan Love et al. Can J Gastroenterol. 2009 Oct.

Erratum in

  • Can J Gastroenterol. 2009 Nov;23(11):784

Abstract
in English, French

Background: Sodium picosulfate with magnesium citrate (PSMC) has been available as a precolonoscopy bowel preparation in Canada since 2005. A high patient acceptability and preference appears to have contributed to its wide adoption across the country. Despite its frequent use, there are relatively few published studies of this product, especially reports regarding its use in routine clinical practice. Moreover, to date, there have been no Canadian studies of any kind.

Objective: To conduct a preliminary evaluation of PSMC by prospectively collecting data describing its effectiveness.

Methods: In the present multicentre, observational study, sequential patients used PSMC according to each institution's standard colonoscopy protocol. Differences in bowel cleansing protocols included dose timing, fluid intake, dietary restrictions and administration of bisacodyl. During colonoscopy, preparation quality was rated separately for the right and left sides of the colon.

Results: Of the 613 patients entered, 606 were evaluable for efficacy. For the right and left colon, respectively, 93.0% and 96.2% of preparations were rated either 'excellent' or 'adequate'. In the 334 patients who received adjunctive bisacodyl and the 272 patients who did not, the results were similar: for the right and left colon, 92.3% and 97.1% of those who did not, and 93.4% and 95.7% of those who did receive bisacodyl, respectively, were rated either 'excellent' or 'adequate'.

Conclusions: Despite the differences in bowel cleansing protocols used at each hospital (including an additional laxative), PSMC consistently yielded a high percentage of positive ratings for efficacy.

HISTORIQUE :: Le picosulfate de sodium avec citrate de magnésium (PSCM) est offert au Canada depuis 2005 pour la préparation à la coloscopie. Son emploi se serait répandu au pays parce qu’il est fort bien accepté des patients qui lui accordent leur préférence. Malgré son utilisation fréquente, relativement peu d’études ont été publiées au sujet de ce produit, particulièrement en ce qui concerne son utilisation dans la pratique clinique de routine. De plus, à ce jour, aucune étude n`a été menée à son sujet au Canada.

OBJECTIF :: Réaliser une évaluation préliminaire du PSCM par le biais d’une collecte de données prospectives décrivant son efficacité.

MÉTHODE :: Dans la présente étude d’observation multicentrique, des patients successifs ont utilisé le PSCM conformément au protocole standard établi pour la coloscopie dans leur établissement. Parmi les différences entre les divers protocoles de préparation du côlon, mentionnons le moment où le produit est pris, la prise de liquides, les restrictions alimentaires et l’administration de bisacodyl. Durant la coloscopie, la qualité de la préparation a été évaluée séparément pour le côlon droit et le côlon gauche.

RÉSULTATS :: Parmi les 613 patients inscrits, 606 ont été jugés évaluables pour ce qui est de l’efficacité. Pour le côlon droit et le côlon gauche respectivement, 93,0 % et 96,2 % des préparations ont été jugées soit « excellentes », soit « adéquates ». Entre les 334 patients qui ont reçu du bisacodyl comme mesure d’appoint et les 272 patients qui n’en ont pas pris, les résultats ont été similaires : pour le côlon droit et le côlon gauche, la préparation a été jugée soit « excellente », soit « adéquate » chez 92,3 % et 97,1 % des sujets qui n’avaient pas pris de bisacodyl et chez 93,4 % et 95,7 % de ceux qui en avaient pris.

CONCLUSION :: Malgré les différences quant aux protocoles de préparation du côlon appliqués dans chaque hôpital (y compris un laxatif additionnel), le PSCM a donné lieu, dans la plupart des cas, à un fort pourcentage de résultats positifs sur le plan de l’efficacité.

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Figures

Figure 1)
Figure 1)
Overall quality of bowel preparation ratings according to site. Values (x/y) shown for ‘Patients rated’ represent the number of patients rated for the right/left side of the colon, respectively. Site 4 inadvertently did not score quality of bowel preparation according to the excellent/adequate/inadequate scale for 90 of its 103 patients. Others sites occasionally missed scoring one or both sides. L Left colon; R Right colon
Figure 2)
Figure 2)
Overall descriptive quality of bowel preparation ratings according to site. Values (x/y) shown for ‘Patients rated’ represent the number of patients rated for the right/left side of the colon, respectively. Some sites occasionally missed scoring one or both sides. Adh Stl Adherent stool; Cln/Dry Clean/dry; Clr Lqd Clear liquid; FOS Full of stool; L Left colon; Mrky Lqd Murky liquid; R Right colon
Figure 3)
Figure 3)
Descriptive quality of bowel preparation ratings with or without addition of bisacodyl. Sodium picosulfate and magnesium citrate (PSMC) plus bisacodyl includes administration of bisacodyl either before, between or after PSMC. Adh Stl Adherent stool; Cln/Dry Clean/dry; Clr Lqd Clear liquid; FOS Full of stool; L Left colon; Mrky Lqd Murky liquid; R Right colon
See this image and copyright information in PMC

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