Abstract
Introduction: Screening colonoscopies are recommended for the detection and prevention of colon cancer. Liquid colonoscopy preparations may be poorly tolerated. We evaluated the adequacy and tolerability of a novel low-cost colonoscopy preparation consisting of magnesium citrate capsules and bisacodyl (MCCB).Methods: This is a single-center, assessor-blinded, randomized controlled trial of 51 patients undergoing screening colonoscopies, who received a bowel preparation of either 4 liters of GoLYTELY (Braintree Laboratories, Inc., Braintree, MA) or MCCB. The primary outcome was the rate of adequate colon cleanliness, defined as a total score ≥ 6 on the Boston Bowel Preparation Scale and no colon segment with a score of zero. The secondary outcome was patient satisfaction, assessed by a validated questionnaire.Results: A total of 100% of patients in both arms achieved adequate colon cleanliness, and the magnesium citrate arm had superior patient satisfaction (mean satisfaction score: 54.8 vs. 172.8; p < 0.001).Conclusions: A pill-based colonoscopy preparation of MCCB may be a low-cost option for patients reluctant to consume a liquid preparation.
Highlights
Screening colonoscopies are recommended for the detection and prevention of colon cancer
We designed and evaluated a magnesium citrate capsule-based preparation, which costs approximately $3, with the hypothesis that it would have reasonable efficacy in colon cleanliness and superior patient satisfaction compared to 4 liters of GoLYTELY (Braintree Laboratories, Inc., Braintree, MA) preparation
Eligible patients were randomized with computerized random numbers, in a 1:1 ratio, to receive either 4 liters of GoLYTELY or magnesium citrate capsules and bisacodyl (MCCB) (Figure 1)
Summary
Screening colonoscopies are recommended for the detection and prevention of colon cancer. Liquid colonoscopy preparations may be poorly tolerated. We evaluated the adequacy and tolerability of a novel low-cost colonoscopy preparation consisting of magnesium citrate capsules and bisacodyl (MCCB). A pill-based preparation is potentially more tolerable to patients [3,4]. Several pill-based preparations have been approved by the Food and Drug Administration (FDA), including OsmoPrep (Salix, Bridgewater, NJ) and Sutab (Braintree Laboratories, Inc., Braintree, MA), but each cost over $100, which limits their widespread utilization [5]. Magnesium citrate liquid is a widely used preparation, and magnesium citrate capsules are commercially available as a supplement. We designed and evaluated a magnesium citrate capsule-based preparation, which costs approximately $3, with the hypothesis that it would have reasonable efficacy in colon cleanliness and superior patient satisfaction compared to 4 liters of GoLYTELY (Braintree Laboratories, Inc., Braintree, MA) preparation
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