Picoprep-3™ Is a Superior Colonoscopy Preparation to Fleet™: A Randomized, Controlled Trial Comparing the Two Bowel Preparations

PURPOSE: Bowel preparations for colonoscopy have to balance the demand for adequate cleansing action of the bowel and patient acceptability. There has been no study comparing Picoprep-3™ (sodium picosulfate), a relatively new product, to Fleet™ (sodium phosphate), a well-studied and widely used preparation. This study was designed to compare the efficacy and patient tolerance of these two bowel preparations for colonoscopy. METHODS: A randomized, single-blinded, prospective trial was conducted. A total of 400 consecutive patients presenting for elective colonoscopy at St George Private Hospital during a 20-week period were randomly assigned to receive Picoprep-3™ or Fleet™. Patients were asked to record the effects of the preparation, noting tolerability, taste, and side effects. Two hundred patients were assigned to the Picoprep-3™ group and 200 to the Fleet™ group. Surgeons were blinded to the preparation used and rated the quality of the bowel preparation on a scale of 1 to 5 (1 being the optimal score). RESULTS: Picoprep-3™ was found to be better tolerated (P < 0.0001) and better tasting (P < 0.0001) than Fleet™. Patients in the Picoprep-3™ group reported significantly less nausea (P < 0.001), vomiting (P < 0.004), dizziness (P < 0.01), abdominal pains (P = 0.0005), and thirst (P < 0.0001) associated with the preparation. There was no significant difference in visualization of the colon between the two groups as judged by the two colonoscopists (P = 0.06). CONCLUSIONS: Colonoscopy preparation with Picoprep-3™ has similar efficacy but superior taste and tolerability compared with Fleet™. Picoprep-3™ caused less adverse side effects in the study population.