A COMPARATIVE STUDY OF COLONOSCOPY PREPARATION WITH 1L PEG+ASCORBIC ACID VS SODIUM PICOSULPHATE WITH MAGNESIUM CITRATE IN REAL-LIFE SETTING: EFFECTIVENESS, AND SAFETY

Aims Preparations based on polyethylene glycol (PEG) and sodium picosulphate with magnesium citrate (SPMC), are first-line options, but comparative data in a real-life setting are lacking. This study aims to compares the effectiveness and safety of low volume 1L PEG+Ascorbic Acid (1L PEG+A) versus SPMC in real-life setting.

Methods Systematic and prospective registry of outpatients prepared with 1L PEG+A and SPMC. Bowel cleansing was assessed through the Boston Bowel Preparation Scale (BBPS) in total and right colon, Polyp Detection Rate (PDR) as the proportion of colonoscopies where at least one polyp was found and removed in total colon. Side effects were recorded.

Results Between July 2019- October 2021, 876 patients were included. Mean age 58 years [18-85].

Table 1

BBPS	1L PEG+A (n=425)	SPMC (n=451)	p
TOTAL COLON	BBPS > 6: 91%	BBPS > 6: 77%	P<0.01
	BBPS > 7: 76%	BBPS > 7: 50%
RIGHT COLON	BBPS > 2: 92%	BBPS > 2: 82%	P<0.01
	BBPS=3: 58%	BBPS=3: 27%
PDR	46%	42%	p>0.05

2% of patients presented vomiting with SPMC and 11% with 1L PEG+A (p<0.01). 5% of patients had nausea with SPMC and 3% with 1L PEG+A (p>0.05). 3% of the patients in 1L PEG+A had sodium levels > 147 mg /dl, all asymptomatic. 9% of the patients in SPMC had sodium levels < 135 mg /dl. 5 women > 65 years had values < 130 mg/dl (one required emergency admission).

Conclusions Preparation with 1L PEG+A obtains optimal and high-quality bowel preparation compared to SPMC. Vomiting does not seem to affect the final efficacy of 1L PEG+A. In SPMC group, 5 cases of hyponatremia with clinical relevance were detected, which could make us assess changes in its use in patients over 65 years.

Publication History

Article published online:
14 April 2022