Document Detail


MiraLAX-Gatorade bowel prep versus GoLytely before screening colonoscopy: an endoscopic database study in a community hospital.
MedLine Citation:
PMID:  23060223     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Polyethylene glycol-3350 without electrolytes (MiraLAX; Schering-Plough Healthcare Products Inc.)+a carbohydrate-electrolyte solution (Gatorade; PepsiCo Inc.)+bisacodyl is frequently used for bowel cleansing, although limited data quantifies its efficacy and safety. No prior studies have assessed this in a community setting or with PM-only dosing, which is still used frequently.
AIM: To compare the frequency of excellent/good/fair/poor bowel cleansing with PM-only dosing of MiraLAX-Gatorade-bisacodyl versus 4-liter GoLytely.
METHODS: This is a retrospective endoscopic database analysis of 50 years and older average-risk individuals with a normal screening colonoscopy at a community hospital and ambulatory endoscopy center. Data were extracted for the last 4 months when 4-liter GoLytely was the preferred bowel purgative and the first 4 months when 238-g MiraLAX in 64-ounce Gatorade and four 5-mg bisacodyl tablets became the preferred purgative. All patients used PM-only dosing of bowel purgative.
RESULTS: A total of 778 subjects [GoLytely (n=395) vs. MiraLAX+Gatorade+bisacodyl (n=383)] were identified. Patients who took the MiraLAX bowel preparation were more likely to achieve an excellent/good bowel cleansing compared with patients taking the GoLytely preparation (93.3% vs. 89.3%, respectively; P=0.048). However, when only American Society of Anesthesiology (ASA) class I patients are studied, there was no difference in frequency of excellent/good bowel cleansing (91.1% vs 93.6%, respectively; P=0.498). No serious adverse events were identified. An excellent/good bowel cleansing was strongly associated with a recommendation for repeat colonoscopy in 10 years compared with patients with a fair cleansing (odds ratio=28.01; 95% confidence interval, 13.96-56.19).
CONCLUSIONS: The MiraLAX+Gatorade+bisacodyl combination produces similar rates of excellent/good bowel cleansing as compared with GoLytely in most average-risk individuals undergoing colonoscopy for colorectal screening in a community setting.
Authors:
Frederick K Shieh; Naresh Gunaratnam; Sagal O Mohamud; Philip Schoenfeld
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  46     ISSN:  1539-2031     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:    2012 Nov-Dec
Date Detail:
Created Date:  2012-10-12     Completed Date:  2013-04-11     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e96-e100     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Bisacodyl / administration & dosage
Cathartics / administration & dosage*
Colonoscopy / methods*,  standards
Confidence Intervals
Early Detection of Cancer / methods
Electrolytes / administration & dosage*
Female
Hospitals, Community
Humans
Isotonic Solutions / administration & dosage*
Male
Middle Aged
Odds Ratio
Polyethylene Glycols / administration & dosage*
Retrospective Moral Judgment
Grant Support
ID/Acronym/Agency:
1K24DK084208/DK/NIDDK NIH HHS; K24 DK084208/DK/NIDDK NIH HHS; R01 DK058369/DK/NIDDK NIH HHS; T32 DK062708/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Cathartics; 0/Electrolytes; 0/Golytely; 0/Isotonic Solutions; 0/Polyethylene Glycols; 0/gatorade; 603-50-9/Bisacodyl
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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