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Split-dose versus day-before regimen of sodium picosulfate plus magnesium citrate for bowel cleansing before

Giovanni Di Nardo1, Enrico Felici2, Letizia Zenzeri1,2,3

  • 1NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy.

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
|November 22, 2022
PubMed

Insights

The split-dose sodium picosulfate plus magnesium citrate (SPMC) regimen significantly improved colon cleansing and patient acceptability compared to the day-before method for pediatric colonoscopy preparation.

Area of Science:

  • Gastroenterology
  • Pediatric Endoscopy
  • Pharmacology

Background:

  • Polyethylene glycol (PEG) split-dose is a recommended colonoscopy preparation.
  • Sodium picosulfate plus magnesium citrate (SPMC) offers comparable efficacy with better tolerability in children.
  • Optimal bowel preparation is crucial for successful pediatric colonoscopy.

Purpose of the Study:

  • To compare the efficacy and acceptability of SPMC split-dose versus day-before regimens for pediatric colonoscopy.
  • To determine if split-dose SPMC is superior for bowel cleansing in children.

Main Methods:

  • Multicenter, randomized, single-blind study in pediatric inpatients.
  • SPMC administered either day-before or split-dose.
  • Bowel cleansing assessed by Boston Bowel Preparation Scale (BBPS); success defined as BBPS ≥6.
  • Patient tolerability, acceptability, and compliance were recorded.

Main Results:

  • Split-dose SPMC achieved a significantly higher rate of successful colon cleansing (BBPS ≥6) than the day-before regimen (P < 0.001).
  • Higher BBPS scores were observed in the split-dose group for the entire colon, right colon, and transverse colon (P < 0.001).
  • The split-dose regimen demonstrated superior patient acceptability (P = 0.0003; P = 0.005) and reduced need for nasogastric tube placement (P = 0.007).

Conclusions:

  • The split-dose regimen of SPMC is superior to the day-before regimen for pediatric colonoscopy preparation.
  • Split-dose SPMC enhances successful colon cleansing and improves patient acceptability.
  • This regimen represents an effective option for pediatric bowel preparation.
Abstract

Keywords:
bowel preparationchildrencolonoscopysplit-dose

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