The effect of oral magnesium-containing bowel preparation agents on mucosal coating by barium sulphate suspensions

Alteration in the quality of mucosal coating by barium sulphate suspension observed during double-contrast barium enema (DCBE) examinations when an oral magnesium-containing purgative (Picolax) was used as sole bowel preparation has been investigated in vivo. Small amounts of Picolax were found to produce a linear increase in apparent viscosity and thixotropy, due to flocculation. The effect of equivalent concentrations of acid was significantly less (p less than 0.01), and of magnesium chloride was significantly greater (p less than 0.05), whereas magnesium citrate was comparable to Picolax, demonstrating the deflocculating effect of citrate on the flocculating action of magnesium ions. It is suggested that colonic residue from orally ingested magnesium-containing purgatives may contain sufficient magnesium ions to increase viscosity of the barium suspension and visibly affect its coating during DCBE.