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Shin, Park, Kim, Moon, Park, Lim, Park, and Lee: Effect of Combination Pretreatment of Polyethylene Glycol Solution and Magnesium Hydroxide for Colonoscopy
Original Article

Korean J Gastroenterol 2010;55(4):232-236.

Published online: 21 February 2010

DOI: https://doi.org/10.4166/kjg.2010.55.4.232

Effect of Combination Pretreatment of Polyethylene Glycol Solution and Magnesium Hydroxide for Colonoscopy

Eun Kyung Shin, M.D., Seun Ja Park, M.D., Kyu Jong Kim, M.D., Won Moon, M.D., Moo In Park, M.D., Dong Han Lim, M.D., Eun Ho Park, M.D., Jee Suk Lee, M.D.

Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea

Correspondence to: Seun Ja Park, M.D. Gastroenterology, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan 602-702, Korea Tel: +82-51-990-5061 Fax: +82-51-990-3005 E-mail: parksj@ns.kosinmed.or.kr

Received 19 September 2009       Accepted 20 January 2010

Copyright © 2010 The Korean Journal of Gastroenterology

Abstract

Background/Aims

This study was designed to compare the efficacy and patient tolerance between standard bowel preparation using 4 liters of polyethylene glycol (PEG) solution and 4 liters of PEG preceded by the osmotic laxative, magnesium hydroxide in constipation and non-constipation group.

Methods

173 outpatient colonoscopy, except for three patients who were not taking magnesium, were divided into constipation and non-constipation group. Then, the patients were randomly assigned to receive 4-liter of PEG solution or 4-liter of PEG plus magnesium hydroxide. The quality of bowel preparation was assessed using Ottawa scale, and satisfaction score was assessed using questionnaires. Solid stool, cecal intubation time, compliance, and side effects were assessed.

Results

Non-constipation group showed no significant differences between two groups. In constipation group, 4-liter PEG solution plus magnesium hydroxide induced the more effective colonic preparation (Ottawa scale 2.47±0.99 vs. 5.92±2.39, p＜0.05), and less solid stool (0.67±0.72 vs. 1.38±0.65, p＜0.05) compared with 4-liter PEG solution.

Conclusions

Bowel preparation with magnesium hydroxide and 4 liters of PEG solution might reduce solid stool in constipation group, but could not improve preparation quality.

Keywords: Colonoscopy, Bowel preparation, Constipation, Magnesium hydroxide, Polyethylene glycol

REFERENCES

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Table 1.
Basic Characteristics of Patient
Non-constipation group Constipation group
Group A (n=67) Group B (n=75) p-value Group C (n=15) Group D (n=13) p-value
Age (mean SD, years) 52.60±13.08 52.80±10.60 0.919 63.73±11.47 59.69±13.09 0.396
Sex (female/male) 26/41 37/38 0.207 11/4 10/3 0.655
BMI (mean± SD, kg/m2) 24.16±3.08 24.89±2.12 0.351 23.50±2.94 23.94±2.82 0.695
History of abdominal surgery 15 15 0.608 4 1 0.333
History of previous colonoscopy y 43 39 0.114 7 8 0.705

SD, standard deviation; BMI, body mass index.

Group A and C, bowel preparation with polyethylene glycol; Group B and D, bowel preparation with polyethylene glycol and magnesium hydroxide.

Table 2.
Ottawa Bowel Preparation Quality Scale
Non-constipation group Constipation group
Group A (n=67) Group B (n=75) p-value Group C (n=15) Group D (n=13) p-value
Right colon 1.33±0.71 1.49±0.78 0.189 0.73±0.46 1.69±0.46 0.000
Mid colon 1.07±0.77 1.01±0.78 0.638 0.20±0.41 1.38±0.65 0.000
Rectosigmoid colon 0.99±0.79 1.05±0.75 0.598 0.80±0.56 1.62±0.87 0.006
Fluid volume 0.94±0.72 0.85±0.67 0.456 0.73±0.59 1.15±0.69 0.094
Ottawa scale 4.33±2.34 4.40±2.19 0.851 2.47±0.99 5.92±2.40 0.000

Group A and C, bowel preparation with polyethylene glycol; Group B and D, bowel preparation with polyethylene glycol and magnesium hydroxide.

Table 3.
Comparison of Suction Volume, Solid Stool and Insertion Time
Non-constipation group Constipation group
Group A (n=67) Group B (n=75) p-value Group C (n=15) Group D (n=13) p-value
Suction volume (mL) 254.03±96.59 259.46±107.08 0.753 263.33±120.22 219.17±65.71 0.265
Solid stool 0.67±0.68 0.77±0.73 0.393 0.67±0.724 1.38±0.65 0.011
Insertion time (mean± SD, min) 6.74±4.65 6.23±4.93 0.532 4.95±2.37 6.21±4.00 0.321

Group A and C, bowel preparation with polyethylene glycol; Group B and D, bowel preparation with polyethylene glycol and magnesium hydroxide.

Table 4.
Comparison of Satisfaction Score
Non-constipation group Constipation group
Group A (n=67) Group B (n=75) p-value Group C (n=15) Group D (n=13) p-value
Endoscopists'satisfaction score 3.13±2.73 2.35±2.08 0.056 1.93±1.83 2.92±2.60 0.250
Patients'satisfaction score 7.42±1.57 7.54±1.39 0.642 7.53±1.25 6.92±1.19 0.197

Group A and C, bowel preparation with polyethylene glycol; Group B and D, bowel preparation with polyethylene glycol and magnesium hydroxide.

Table 5.
Comparison of Side Effect
Non-constipation group Constipation group
Group A (n=67) Group B (n=75) p-value Group C (n=15) Group D (n=13) p-value
Side effect after preparation
   Nausea 46 52 0.740 10 13 0.065
   Vomiting 23 22 0.596 6 7 0.464
   Abdominal pain 4 2 0.426 1 1 0.426
   Abdominal bloating 11 8 0.346 2 2 1.000
   The others 1 2 0.611 0 0
Side effect after colonoscopy
   Nausea 0 0 0 0
   Vomiting 0 0 0 0
   Abdominal pain 11 10 0.626 3 2 1.000
   Abdominal bloating 10 15 0.408 4 2 0.655
   Weakness 11 15 0.558 0 2 0.206

Group A and C, bowel preparation with polyethylene glycol; Group B and D, bowel preparation with polyethylene glycol and magnesium hydroxide.

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