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Effectiveness of Sodium Picosulfate/Magnesium Citrate (PICO) for Colonoscopy Preparation

대한대장항문학회지 2014년 30권 5호 p.222 ~ 227
 ( Song Ki-Hwan ) - Goo Hospital Coloproctology Center

 ( Suh Wu-Seok ) - Goo Hospital Coloproctology Center
 ( Jeong Jin-Sik ) - Goo Hospital Coloproctology Center
 ( Kim Dong-Sik ) - Goo Hospital Coloproctology Center
 ( Kim Sang-Woo ) - Goo Hospital Coloproctology Center
 ( Kwak Dong-Min ) - Goo Hospital Coloproctology Center
 ( Hwang Jong-Seong ) - Goo Hospital Coloproctology Center
 ( Kim Hyun-Jin ) - Goo Hospital Coloproctology Center
 ( Park Man-Woo ) - Goo Hospital Coloproctology Center
 ( Shim Min-Chul ) - Goo Hospital Coloproctology Center
 ( Koo Ja-Il ) - Goo Hospital Coloproctology Center
 ( Kim Jae-Hwang ) - Yeungnam University School of Medicine Department of Surgery
 ( Shon Dae-Ho ) - Hwanggeumbit Hakmoon Colorectal Surgery Clinic


Purpose: Bowel preparation with sodium phosphate was recently prohibited by the U.S. Food and Drug Administration. Polyethylene glycol (PEG) is safe and effective; however, it is difficult to drink. To identify an easy bowel preparation method for colonoscopy, we evaluated three different bowel preparation regimens regarding their efficacy and patient satisfaction.

Methods: In this randomized, comparative study, 892 patients who visited a secondary referral hospital for a colonoscopy between November 2012 and February 2013 were enrolled. Three regimens were evaluated: three packets of sodium picosulfate/magnesium citrate (PICO, group A), two packets of PICO with 1 L of PEG (PICO + PEG 1 L, group B), and two packets of PICO with 2 L of PEG (PICO + PEG 2 L, group C). A questionnaire survey regarding the patients’ preference for the bowel preparation regimen and satisfaction was conducted before the colonoscopies. The quality of bowel cleansing was scored by the colonoscopists who used the Aronchick scoring scale and the Ottawa scale.

Results: The patients’ satisfaction rate regarding the regimens were 72% in group A, 64% in group B, and 45.9% in group C. Nausea and abdominal bloating caused by the regimens were more frequent in group C than in group A or group B (P < 0.01). Group C showed the lowest preference rate compared to the other groups (P < 0.01). Group C showed better right colon cleansing efficacy than group A or group B.

Conclusion: Group A exhibited a better result than group B or group C in patient satisfaction and preference. In the cleansing quality, no difference was noted between groups A and C.


Sodium picosulfate magnesium citrate; Satisfaction; Bowel preparation; Polyethylene glycols; Colonoscopy
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