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. 1995 Aug;71(838):476–479. doi: 10.1136/pgmj.71.838.476

The quest for a more acceptable bowel preparation: comparison of a polyethylene glycol/electrolyte solution and a mannitol/Picolax mixture for colonoscopy.

B P Saunders 1, T Masaki 1, M Fukumoto 1, S Halligan 1, C B Williams 1
PMCID: PMC2398200  PMID: 7567754

Abstract

Eighty-nine consecutive patients attending for day-case colonoscopy were randomly allocated either polyethylene glycol/balanced electrolyte (PEG) mixture (n = 45) or a mannitol/Picolax mixture (n = 44). Both preparations were administered in two fractions. Patients recorded their experience of the preparation on a questionnaire and one of two experienced endoscopists (unaware of the type of preparation given) assessed the result of bowel cleansing. Carbon dioxide insufflation was used for all examinations. Good/excellent bowel cleansing occurred in significantly more patients given PEG, 43 (96%), than those allocated mannitol/Picolax, 34 (77%), p = 0.01. More patients receiving mannitol/Picolax were able to complete the preparation in full than patients receiving PEG (38 vs 27, p = 0.01). More patients found the taste of mannitol/Picolax pleasant compared to PEG (46% vs 20%). Both preparations had a similar side-effect profile. Of those patients tested, 13% receiving mannitol/Picolax had a postural drop in blood pressure and blood parameters suggestive of mild dehydration. A fractionated administration of PEG as a bowel preparation for day-case colonoscopy is well tolerated and superior as a cleansing agent to a mannitol/Picolax combination. Provided carbon dioxide is used as the insufflating agent, mannitol/Picolax is an acceptable alternative in fit, young patients intolerant of PEG.

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Selected References

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  1. Adler M., Quenon M., Even-Adin D., Jeanmart J., Van Gossum A., Bourgeois N., Cremer M. Whole gut lavage for colonoscopy--a comparison between two solutions. Gastrointest Endosc. 1984 Apr;30(2):65–67. doi: 10.1016/s0016-5107(84)72318-2. [DOI] [PubMed] [Google Scholar]
  2. Bigard M. A., Gaucher P., Lassalle C. Fatal colonic explosion during colonoscopic polypectomy. Gastroenterology. 1979 Dec;77(6):1307–1310. [PubMed] [Google Scholar]
  3. Brown J. J., Jewell D. P. Outpatient preparation for colonoscopy. Lancet. 1981 Sep 26;2(8248):695–695. doi: 10.1016/s0140-6736(81)91028-x. [DOI] [PubMed] [Google Scholar]
  4. Burke D. A., Manning A. P., Murphy L., Axon A. T. Oral bowel lavage preparation for colonoscopy. Postgrad Med J. 1988 Oct;64(756):772–774. doi: 10.1136/pgmj.64.756.772. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dakkak M., Aziz K., Bennett J. R. Short report: comparison of two orally administered bowel preparations for colonoscopy--polyethylene glycol and sodium picosulphate. Aliment Pharmacol Ther. 1992 Aug;6(4):513–519. doi: 10.1111/j.1365-2036.1992.tb00566.x. [DOI] [PubMed] [Google Scholar]
  6. Davis G. R., Santa Ana C. A., Morawski S. G., Fordtran J. S. Development of a lavage solution associated with minimal water and electrolyte absorption or secretion. Gastroenterology. 1980 May;78(5 Pt 1):991–995. [PubMed] [Google Scholar]
  7. Di Febo G., Gizzi G., Caló G., Siringo S., Brunetti G. Comparison of a new colon lavage solution (Iso-Giuliani) with a standard preparation for colonoscopy: a randomized study. Endoscopy. 1990 Sep;22(5):214–216. doi: 10.1055/s-2007-1012851. [DOI] [PubMed] [Google Scholar]
  8. DiPalma J. A., Brady C. E., 3rd, Stewart D. L., Karlin D. A., McKinney M. K., Clement D. J., Coleman T. W., Pierson W. P. Comparison of colon cleansing methods in preparation for colonoscopy. Gastroenterology. 1984 May;86(5 Pt 1):856–860. [PubMed] [Google Scholar]
  9. Froehlich F., Fried M., Schnegg J. F., Gonvers J. J. Palatability of a new solution compared with standard polyethylene glycol solution for gastrointestinal lavage. Gastrointest Endosc. 1991 May-Jun;37(3):325–328. doi: 10.1016/s0016-5107(91)70724-4. [DOI] [PubMed] [Google Scholar]
  10. Hangartner P. J., Münch R., Meier J., Ammann R., Bühler H. Comparison of three colon cleansing methods: evaluation of a randomized clinical trial with 300 ambulatory patients. Endoscopy. 1989 Nov;21(6):272–275. doi: 10.1055/s-2007-1012967. [DOI] [PubMed] [Google Scholar]
  11. Lubowski D., de Carle D., Hunt D. R. Colonic lavage with polyethylene glycol. Med J Aust. 1985 Feb 18;142(4):256–256. doi: 10.5694/j.1326-5377.1985.tb113325.x. [DOI] [PubMed] [Google Scholar]
  12. Roe A. M., Jamison M. H., MacLennan I. Colonoscopy preparation with Picolax. J R Coll Surg Edinb. 1984 Mar;29(2):103–104. [PubMed] [Google Scholar]
  13. Rösch T., Classen M. Fractional cleansing of the large bowel with "Golytely" for colonoscopic preparation: a controlled trial. Endoscopy. 1987 Sep;19(5):198–200. doi: 10.1055/s-2007-1018281. [DOI] [PubMed] [Google Scholar]
  14. Taylor E. W., Bentley S., Youngs D., Keighley M. R. Bowel preparation and the safety of colonoscopic polypectomy. Gastroenterology. 1981 Jul;81(1):1–4. [PubMed] [Google Scholar]
  15. Teague R. H., Manning A. P. Preparation of the large bowel for endoscopy. J Int Med Res. 1977;5(5):374–377. doi: 10.1177/030006057700500515. [DOI] [PubMed] [Google Scholar]

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