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IS PICOSALAX BETTER THAN MAGNESIUM CITRATE IN THE PREPARATION FOR COLONOSCOPY IN CHILDREN?
D Haas, M Boland, D Mack, J Barkey, C Jimenez-Rivera
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario
Aims: Our aim was to compare two bowel cleansing solutions (Picosalax vs magnesium citrate) in preparation for colonoscopy.
Methods: The study was a retrospective chart review of all patients seen in Gastroenterology outpatient clinic that underwent bowel cleansing in preparation for colonoscopy from February to December 2006 at the Children's Hospital of Eastern Ontario.
Results: There were a total of 68 children included in the study, 32 received Picosalax (picosulphate and magnesium oxide) and 36 received magnesium citrate. Children form 1 to 6 years of age used ¼ sachet, 6 to 12 years received ½ sachet and from 12 to 18 years they received 1 sachet of Picosalax once per day for two consecutive days. Oral magnesium citrate was provided at a dose of 60 ml in children between 10 to 15 kg, 90 ml in children between 16 and 20 kg, 150 ml in children between 21 to35 kg and 300 ml for children >36 kg for two consecutive days. Both groups received either dulcolax or castor oil depending on their abilities to swallow pills. Both groups had to follow a liquid diet 48 hours before the procedure. Mean age was 11.9 years (range 2.9 to 17.3 years). Tolerability of both solutions was similar, vomiting and abdominal discomfort were the most common complaints which accounted for 3% for Picosalax and 11% for magnesium citrate (p=0.6). Most children had liquid stools in both groups (75% vs 92% Picosalax and magnesium citrate respectively; p=0.11). Twenty eight percent of children receiving Picosalax had complete colonoscopy without need of suctioning compared with only 14% of children receiving magnesium citrate (p=0.38). Two patients, one in each group had incomplete procedure due to presence of stools. There was no diference between age and tolerability of solution as well as ease of scope or stool type.
Conclusions: Picosalax seemed to be better tolerated in children undergoing colonoscopy, however without statistical significance. Bowel preparation for colonoscopy can be successfully achieved by either picosalax or magnesium citrate. Larger randomized controlled studies are needed to assess efficacy, tolerability and ease of colonoscopy with the available solutions.