Springer Online Journal Archives 1860-2000
Abstract An osmotic laxative containing polyethylene glycol and sodium sulfate (Golytely® Braintree Laboratories, Inc., Braintree, MA) is widely used to clean the colon for colonoscopy. However, its salty taste makes the mixture unpalatable. We therefore tested the claim that a similar solution but without sodium sulfate (Golytely-RSS® Braintree Laboratories, Inc., Braintree, MA) makes preparation of the colon more acceptable to patients in a double-blinded randomized controlled trial. Colonic preparation using polyethylene glycol with or without sodium sulfate was randomized in 100 patients due to undergo colonoscopy. The overall acceptability of the regimen was measured on a linear analogue scale and an estimate of symptoms was obtained. Body weight and serum electrolytes, urea, creatinine, hemoglobin and hematocrit were determined before and after preparation in order to assess fluid absorption. The efficacy of colonic cleansing was graded by the colonoscopist. Four patients did not complete the protocol, 47 received the regimen containing sodium sulfate and 49 received the regimen without it. The two groups did not differ in age or body mass. There was no statistical difference in the overall acceptability of the two regimens to the patients (median acceptability rating 74 for regimen with sodium sulfate, range 4–100 compared with 77 for regimen without, range 3–100, p=0.32, Mann-Whitney test). Nor was there any difference in taste, nausea, vomiting, cramping or perianal discomfort or in the endoscopists' rating of the cleanliness of the colon. The serum sodium concentration rose slightly (mean 1.6 mmol/L) when the regimen with sodium sulfate was used. Moreover, prescribing the laxative regimen without sodium sulfate increased the cost of the regimen by 65 percent. In preparing the colon for colonoscopy, omitting sodium sulfate from the conventional mixture of polyethylene glycol and sodium sulfate does not make the preparation more acceptable to patients, does not affect the cleanliness of the colon and increases the cost of the laxative substantially. Golytely® is therefore preferable to Golytely-RSS®.
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