Efficacy and safety of split-dose ultra-low-volume polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate for bowel preparation: a systematic review and meta-analysis.
Abdallfatah Abdallfatah, Ahmed W Hageen, Dania Albader et al.
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In 30 seconds
This systematic review and meta-analysis compared split-dose ultra-low-volume polyethylene glycol with ascorbic acid (PEG + Asc) against sodium picosulfate with magnesium citrate for colonoscopy bowel preparation. Six studies involving 3285 patients were included. Overall and right-sided colon adequate cleansing rates did not differ significantly between regimens (risk ratios 1.05 and 1.03, respectively). PEG + Asc was associated with a significantly lower vomiting rate, while nausea, abdominal pain, and overall Boston Bowel Preparation Scale scores showed no significant differences. Evidence quality varied across outcomes.
Key findings
- Overall adequate cleansing did not differ significantly: risk ratio 1.05, 95% CI: 0.99-1.12, P = 0.1082.
- Right-sided colon adequate cleansing did not differ significantly: risk ratio 1.03, 95% CI: 0.99-1.08, P = 0.1755.
- PEG + Asc had a significantly lower vomiting rate than sodium picosulfate with magnesium citrate (risk ratio: 2.58, 95% CI: 0.94-2.78, P = 0.0008).
- Nausea, abdominal pain, and overall Boston Bowel Preparation Scale scores showed no significant differences.
Why it matters
Adequate bowel cleansing is important for colonoscopy, and these pooled findings suggest that both regimens provide comparable overall and right-sided cleansing. The lower vomiting rate reported with PEG + Asc may be relevant when considering tolerability. However, evidence quality varied, so the findings should be interpreted cautiously rather than treated as definitive evidence of superiority.
What to keep in mind
The review included six studies, and the authors report that evidence quality varied across outcomes.