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Colonoscopy preparation options

High volume

PEG based bowel preparation

  • Gold standard
  • Isoosmotic agent, useful in patients where you want to avoid major shifts in fluid-electrolyte balance i.e. cardiac or renal patients
  • Total 4 L solution, consumed

Low volume

  • Sodium picosulfate (i.e. Pico-Salax)
    • Picosulfate sodium (stimulant laxative)
    • Magnesium oxide (osmotic laxative)
    • Citric acid (osmotic laxative)
  • Sodium sulfate
  • PEG + additional agent

Add powder mixture to 150 mL glass of water and drink it. Then do it again 6 hours later.

Cannot be used in patients who cannot tolerate major electrolyte shifts which include

  • AKI or CKD
  • Heart failure
  • End stage liver disease
  • Pre-existing electrolyte abnormalities