Randomised clinical trial: MiraLAX vs. Golytely - a controlled study of efficacy and patient tolerability in bowel preparation for colonoscopy.

BACKGROUND: MiraLAX is gaining acceptance as a bowel cleanser for colonoscopy. We hypothesize that MiraLAX/Gatorade is as efficacious for bowel cleansing as Golytely and is more tolerable for patients undergoing screening colonoscopy.

AIM: To compare bowel preparation scores of MiraLAX/Gatorade vs. Golytely and examine differences in patient tolerability.

METHODS:   Patients undergoing screening colonoscopy were randomized to 4 L Golytely or 238 g MiraLAX in 64 ounces Golytely and four bisacodyl tablets. Efficacy in bowel cleansing was assessed using the Boston Bowel Preparation Scale (BPPS). Subjects completed a brief survey assessing patient tolerability.

RESULTS: A total of 190 patients were enrolled (85 male, 105 female; mean age 56.9 years, s.d. 6.3); 87 were randomized to MiraLAX, 103 to Golytely. There was no difference in age, gender or timing of colonoscopy between the bowel preparation groups. Golytely's median total BBPS score was significantly higher than that of MiraLAX [9 (IQR 7-9) vs. 8 (IQR 6-9), P = 0.034]. Golytely had a higher rate of an excellent equivalent BBPS score of 8 or 9 than MiraLAX (70% vs. 55%, P = 0.036). There was no difference in patient tolerability (P = 0.857).

CONCLUSIONS: Golytely was more efficacious than MiraLAX/Gatorade in bowel cleansing; both preparations were equally tolerated by patients.