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The quest for a more acceptable bowel preparation: comparison of a polyethylene glycol/electrolyte solution and a mannitol/Picolax mixture for colonoscopy.
  1. B. P. Saunders,
  2. T. Masaki,
  3. M. Fukumoto,
  4. S. Halligan,
  5. C. B. Williams
  1. Department of Endoscopy, St Mark's Hospital, London, UK.


    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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