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Comparison Between Same-Day and Split-Dose Preparations with Sodium Picosulfate/Magnesium Citrate: A Randomized Noninferiority Study

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Abstract

Background

Sodium picosulfate/magnesium citrate (SPMC) is a small-volume bowel cleansing agent with similar efficacy to and better tolerability than polyethylene glycol. However, we found no data on which SPMC preparation (same-day vs. split-dose) provides better bowel cleansing efficacy for afternoon colonoscopy.

Aims

To compare bowel cleansing efficacy of different timing of the regimen.

Methods

This randomized, single-center, endoscopist-blinded, noninferior study compared same-day and split-dose SPMC preparations for afternoon colonoscopy in 101 and 96 patients, respectively. We also included a prospective observation group of 100 patients receiving morning colonoscopy to compare bowel preparation between morning and afternoon colonoscopies. Bowel cleansing efficacy was then evaluated by the Aronchick Scale, Ottawa Bowel Preparation Scale (OBPS), Boston Bowel Preparation Scale (BBPS), and the Bubble Scale.

Results

Same-day and split-dose preparations were similar in efficacy in all four scales. In the Aronchick Scale, the success rate (excellent and good cleanliness) was higher in same-day preparation than in split-dose preparation (100% vs. 92.8%). The same-day preparation also obtained a better OBPS score (1.4 vs. 2.1), but BBPS showed no difference between such groups (7.7 vs. 7.4).

Conclusion

Same-day preparation with SPMC is not inferior to split-dose preparation for afternoon colonoscopy.

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Acknowledgments

The authors received funding from Changhua Christian Hospital (110-CCHIRP-020 and 109-CCH-IRP-008).

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Author notes

  1. Chen-Ta Yang and Hsuan-Yuan Huang contributed equally to this work

Authors and Affiliations

  1. Division of Gastroenterology, Changhua Christian Hospital, Changhua Christian Hospital, Changhua, 500, Taiwan

    Chen-Ta Yang, Hsu-Heng Yen, Chia-Wei Yang, Yang-Yuan Chen & Siou-Ping Huang

  2. Division of Colorectal Surgery, Changhua Christian Hospital, Changhua, Taiwan

    Hsuan-Yuan Huang

  3. General Education Center, Chienkuo Technology University, Changhua, Taiwan

    Hsu-Heng Yen

  4. Artificial Intelligence Development Center, Changhua Christian Hospital, Changhua, Taiwan

    Hsu-Heng Yen

  5. College of Medicine, National Chung Hsing University, Taichung, Taiwan

    Hsu-Heng Yen

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  1. Chen-Ta Yang
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  4. Chia-Wei Yang
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Corresponding author

Correspondence to Hsu-Heng Yen.

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Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board (IRB) of Changhua Christian Hospital (IRB number: CCH IRB No 181216).

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Yang, CT., Huang, HY., Yen, HH. et al. Comparison Between Same-Day and Split-Dose Preparations with Sodium Picosulfate/Magnesium Citrate: A Randomized Noninferiority Study. Dig Dis Sci 67, 3964–3975 (2022). https://doi.org/10.1007/s10620-021-07265-y

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  • DOI: https://doi.org/10.1007/s10620-021-07265-y

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