Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2021; 9(15): 3586-3596
Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3586
Cleansing efficacy and safety of bowel preparation protocol using sodium picosulfate/magnesium citrate considering subjective experiences: An observational study
Fang-Xun Liu, Li Wang, Wen-Jie Yan, Li-Chun Zou, Yue-An Cao, Xiang-Chun Lin
Fang-Xun Liu, Wen-Jie Yan, Li-Chun Zou, Yue-An Cao, Department of International Medical Center, Peking University International Hospital, Beijing 102206, China
Li Wang, Xiang-Chun Lin, Department of Gastroenterology, Peking University International Hospital, Beijing 102206, China
Author contributions: Liu FX was both the investigator and the designer of the study; Cao YA and Lin XC were involved with study design; Liu FX, Wang L, Yan WJ and Zou LC participated in the acquisition, analysis and interpretation of the data and drafted the initial manuscript; All authors critically revised the article and approved the article for publication.
Supported by Beijing Science and Technology Program, China, Early Endoscopic Diagnosis for Colorectal Cancer—The Guidance Study, No. D17110002617002.
Institutional review board statement: The study was reviewed and approved by the Science and Peking University International Hospital (Beijing).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist-of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yue-An Cao, BMed, Chief Doctor, Department of International Medical Center, Peking University International Hospital, No. 1 Life Park Road, Life Science Park of Zhong Guancun, Changping District, Beijing 102206, China. caoyuean@pkuih.edu.cn
Received: February 4, 2021
Peer-review started: February 4, 2021
First decision: March 7, 2021
Revised: March 17, 2021
Accepted: March 23, 2021
Article in press: March 23, 2021
Published online: May 26, 2021
Processing time: 96 Days and 8.7 Hours
Abstract
BACKGROUND

Research data from patient reports indicate that the least bearable part of colonoscopy is the administration of laxatives for bowel preparation.

AIM

To observe the intestinal cleansing efficacy and safety of sodium picosulfate/magnesium citrate and to discuss the patients’ experiences due to the procedure.

METHODS

Subjects hospitalized in the International Medical Center Ward of Peking University International Hospital, Beijing, China, from April 29 to October 29, 2020, for whom the colonoscopy was planned, were enrolled. Bowel preparation was performed using sodium picosulfate/magnesium citrate. The effect of bowel cleansing was evaluated according to the Ottawa Bowel Preparation Scale, defecation conditions and adverse reactions were recorded, and the comfort level and subjective satisfaction concerning medication were evaluated by the visual analogue scale/score (VAS).

RESULTS

The bowel preparation procedure was planned for all patients enrolled, which included 42 males and 22 females. The results showed an average liquid rehydration volume of 3000 mL, an average onset of action for the first dose at 89.04 min, an average number of bowel movements of 4.3 following the first dose, an average onset of action for the second dose at 38.90 min and an average number of bowel movements of 5.0 after the second dose. The total average Ottawa Bowel Preparation Scale score was 3.6, with 93.55% of bowel preparations in the “qualified” and 67.74% in the “excellent” grade. The average VAS score of effect on sleep was 0, and the average VAS score of perianal pain was also 0. The average VAS score for ease of taking and taste perception of the bowel cleanser was 10. Side effects included mild to moderate nausea (15.63%), mild vomiting (4.69%), mild to moderate abdominal pain (7.81%), mild to moderate abdominal distension (20.31%), mild palpitation (7.81%) and mild dizziness (4.69%).

CONCLUSION

Sodium picosulfate/magnesium citrate is effective and safe for bowel preparation before colonoscopy with high subjective patient acceptance, thus improving overall patient compliance.

Keywords: Sodium picosulfate/magnesium citrate; Bowel preparation; Cleansing efficacy; Adverse event

Core Tip: At present, intestinal cleansers commonly used in clinical practice are not yet able to fully meet their ideal requirements including efficacy, safety, affordability, better patient tolerance and acceptance. In our research, the “qualified’ bowel preparation rate achieved with sodium picosulfate/magnesium citrate was 93.55%, whereas the “excellent’ rate was 67.74%. Age and a personal history of constipation are independent risk factors that affect the optimal bowel preparation rate. Furthermore, we performed a statistical analysis on defecation. The results showed a low incidence of adverse reactions and good palatability, thereby improving the overall bowel preparation experience and subsequent patient compliance.