Intest Res.  2019 Jul;17(3):413-418. 10.5217/ir.2018.00156.

Clinical comparison of low-volume agents (oral sulfate solution and sodium picosulfate with magnesium citrate) for bowel preparation: the EASE study

  • 1Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
  • 3Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.
  • 4Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
  • 5Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea.
  • 6Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
  • 7Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
  • 9Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
  • 10Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 11Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
  • 12Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
  • 13Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea.


This study compared the efficacy, compliance, and safety of bowel preparation between sodium picosulfate with magnesium citrate (SPMC) and oral sulfate solution (OSS).
A prospective randomized multicenter study was performed. Split preparation methods were performed in both groups; the SPMC group, 2 sachets on the day before, and 1 sachet on the day of the procedure, the OSS group, half of the OSS with 1 L of water on both the day before and the day of the procedure. The adenoma detection rate (ADR), adequacy of bowel preparation using the Boston Bowel Preparation Scale (BBPS) score, patient satisfaction on a visual analog scale (VAS), and safety were compared between the 2 groups.
This study analyzed 229 patients (121 in the SPMC group and 108 in the OSS group). ADR showed no differences between 2 groups (51.7% vs. 41.7%, P>0.05). The mean total BBPS score (7.95 vs. 8.11, P>0.05) and adequate bowel preparation rate (94.9% vs. 96.3%, P>0.05) were similar between the 2 groups. The mean VAS score for taste (7.62 vs. 6.87, P=0.006) was significantly higher in the SPMC group than in the OSS group. There were no significant differences in any other safety variables between the 2 groups except nausea symptom (36.1% vs. 20.3%, P=0.008).
Bowel preparation for colonoscopy using low volume OSS and SPMC yielded similar ADRs and levels of efficacy. SPMC had higher levels of satisfaction for taste and feeling than did OSS.


Colonoscopy; Bowel preparation; Oral sulfate solution; Sodium picosulfate with magnesium citrate
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