EFFECTIVENESS AND TOLERABILITY OF COLONOSCOPY PREPARATION WITH 1L PEG+ASCORBIC ACID VERSUS SODIUM PICOSULPHATE WITH MAGNESIUM CITRATE IN ELDERLY PATIENTS IN A REAL LIFE SETTING

Aims Inadequate intestinal cleansing is significantly more common in elderly patients, so colonoscopy is considered more challenging than usual due to the difficulty of preparation in this population. This study aims to compares the effectiveness and tolerability of a low volume 1L polyethylene glycol (PEG)+ascorbic acid (1L PEG+A) versus Sodium Picosulphate with Magnesium Citrate (SPMC) in patients≥65 years old.

Methods Post-hoc analysis of a systematic and prospective registry of outpatients prepared with 1L PEG+A and SPMC in patients≥65 years old. Bowel cleansing in total and right colon was assessed through the Boston Bowel Preparation Scale (BBPS). Tolerance and side effects were recorded.

Results Between July 2019 and October 2021, 876 patients were included, of which 272 (31%) were≥65 years old.

Table 1 Cleansing success rates in total colon and the right colon.

BBPS	1L PEG+A (n=156)	SPMC (n=116)	p
TOTAL COLON	BBPS > 6: 93%	BBPS > 6: 78%	P<0.01
	BBPS > 7: 79%	BBPS > 7: 47%
RIGHT COLON	BBPS > 2: 92%	BBPS > 2: 81%	P<0.01
	BBPS=3: 65%	BBPS=3: 28%

Tolerance in SPMC and 1L PEG+A group was good in 88% and 86%, moderate in 7% and 4% and poor in 5% and 10% of the patients respectively (p>0.05). 5 women in SPMC group had values < 130 mg/dl (one required emergency admission).

Conclusions Preparation for colonoscopy with 1L PEG+A achieves better optimal and high-quality bowel preparation compared to SPMC in patients > 65 years. Hyponatremia with clinical relevance were detected in SPMC group, which could make us assess changes in its use in elderly patients. These results confirm the effectiveness and tolerability of 1L PEG+A in elderly patients in a real-life setting.

Publication History

Article published online:
14 April 2022