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Endoscopy 2009; 41(12): 1038-1045
DOI: 10.1055/s-0029-1215333
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Pico-Salax versus polyethylene glycol for bowel cleanout before colonoscopy in children: a randomized controlled trial

D.  Turner1 , E.  I.  Benchimol1 , H.  Dunn2 , A.  M.  Griffiths1 , K.  Frost1 , V.  Scaini1 , J.  Avolio1 , S.  C.  Ling1
  • 1Division of Gastroenterology, Hepatology and Nutrition; The Hospital for Sick Children, University of Toronto, Toronto, Canada
  • 2Day Care Unit, The Hospital for Sick Children, University of Toronto, Toronto, Canada
Further Information

Publication History

submitted 17 December 2008

accepted after revision 4 August 2009

Publication Date:
04 December 2009 (online)

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Background and study aims: Comparison of bowel preparation for colonoscopy in children with either Pico-Salax (sodium picosulphate with magnesium citrate) or polyethylene glycol with electrolyte solution (PEG-ELS).

Patients and methods: In this investigator-blinded, randomized controlled trial, 83 children (12.5 ± 3.1 years) requiring elective colonoscopy at a referral hospital were randomly allocated to Pico-Salax (n = 43) or PEG-ELS (n = 40), and an intention-to treat analysis was applied. Pico-Salax was administered in two doses, one the evening before and one on the morning of the procedure. PEG-ELS was administered over 4 hours. Efficacy was scored using the Ottawa scale and other constructs. Tolerability and toxicity were measured by patient and nursing questionnaires and serum biochemistry.

Results: 35 of Pico-Salax patients (81 %) were satisfied or very satisfied with the cleanout, compared with 19 (48 %) in the PEG-ELS group (P = 0.001). No differences were found in bowel cleanout effectiveness, as judged by the Ottawa score (P = 0.24), completion rates (P = 0.69), colonoscopy duration (P = 0.59), need for enemas (P = 0.25), or physician’s global impression (P = 0.7). Except for one case of mild dehydration in the Pico-Salax group, no clinically significant adverse events were recorded. Serum biochemistry results were similar between groups except for more hypermagnesemia associated with Pico-Salax and hypokalemia with PEG-ELS; neither was clinically significant.

Conclusion: Children tolerate Pico-Salax better than PEG-ELS for bowel cleanout before colonoscopy. This study did not demonstrate superiority of effectiveness or safety for either regimen.

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D. TurnerMD, PhD 

Pediatric Gastroenterology Unit
Shaare Zedek Medical Center

P.O.B 3235
Jerusalem 91031
Israel

Fax: +972-2-6555756

Email: turnerd@szmc.org.il

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