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

D Turner1, E I Benchimol, H Dunn

  • 1Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Canada. turnerd@szmc.org.il

Endoscopy
|December 8, 2009
PubMed

Insights

Pico-Salax demonstrated better tolerability than polyethylene glycol with electrolyte solution (PEG-ELS) for pediatric bowel preparation before colonoscopy. However, neither regimen showed superiority in effectiveness or safety for children undergoing the procedure.

Area of Science:

  • Pediatric Gastroenterology
  • Endoscopy Procedures
  • Gastrointestinal Motility Agents

Background:

  • Effective bowel preparation is crucial for successful pediatric colonoscopy.
  • Pico-Salax (sodium picosulphate with magnesium citrate) and PEG-ELS are common bowel cleansing agents.
  • Comparative data on their efficacy and tolerability in children is limited.

Purpose of the Study:

  • To compare the efficacy and tolerability of Pico-Salax versus PEG-ELS for bowel preparation in children undergoing colonoscopy.
  • To assess patient satisfaction, bowel cleanout effectiveness, and safety profiles of both agents.

Main Methods:

  • Investigator-blinded, randomized controlled trial involving 83 children (mean age 12.5 years).
  • Children received either Pico-Salax (two doses) or PEG-ELS (administered over 4 hours).
  • Efficacy assessed by Ottawa scale; tolerability and safety by questionnaires and serum biochemistry.

Main Results:

  • Significantly higher patient satisfaction with Pico-Salax (81%) compared to PEG-ELS (48%) (P=0.001).
  • No significant differences in bowel cleanout effectiveness (Ottawa score, completion rates) or procedure duration.
  • No clinically significant adverse events; mild dehydration in one Pico-Salax patient; transient hypermagnesemia (Pico-Salax) and hypokalemia (PEG-ELS) noted but not clinically significant.

Conclusions:

  • Pico-Salax is better tolerated by children for bowel preparation prior to colonoscopy compared to PEG-ELS.
  • This study did not establish superiority of either regimen in terms of bowel cleanout effectiveness or overall safety.
  • Pico-Salax may be a preferred option for pediatric bowel preparation due to improved patient tolerance.
Abstract

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