The College of Pharmacy discussed the MSc thesis entitled “Comparing the Effectiveness and Tolerability of Polyethylene Glycol vs. Sodium Picosulphate for Bowel Preparation in Patients Undergoing Colonoscopy” by the student Hala Wahhab Baiee and the supervisors, Assistant Professor Dr. Mohammed Yawuz Jamal and Lecturer. Dr. Ahmed Abdul Hussein Alhilly, at the Clinical Pharmacy Department.
The study aimed to compare the efficacy, tolerability, side effects, and colonoscopy completion rate of PEG-ELS with SPMC as the primary objective, and secondarily to explore the perspectives of endoscopy specialists regarding patient preparation before undergoing colonoscopy.
The study included a mixed-methods design, consisting of a quantitative phase conducted as a single-blind prospective quasi-experimental comparative study, and a qualitative phase involving interviews with endoscopy specialists. Both phases were carried out concurrently at two major gastroenterology centers in Baghdad and Babel governorates from January to June 2025. The study recruited adult outpatients scheduled for colonoscopy, who were divided into two groups: PEG-ELS and SPMC. A structured questionnaire was used to assess patient acceptability, side effects, and efficacy, while the Boston Bowel Preparation Scale (BBPS) was used to document efficacy. Colonoscopy completion rates were recorded by endoscopists blinded to the treatment details, and semi-structured interviews were conducted with endoscopists from the same centers to explore their preferences and recommendations before the procedure.
The results showed that both PEG-ELS and SPMC solutions achieved acceptable bowel cleansing; however, SPMC was associated with better patient tolerability, higher comfort levels, fewer side effects, improved cleansing quality, higher colonoscopy completion rates, and a greater willingness to repeat the procedure. Endoscopy specialists’ opinions confirmed that patient tolerability for both agents—which is influenced by taste, fluid volume, and quality of patient education—plays a key role in successful preparation despite their efficacy.
The study recommended routinely adopting a split-dose regimen while simplifying and standardizing dietary instructions before colonoscopy, and prioritizing low-volume, more palatable preparations such as sodium picosulfate, especially for patients who have difficulty tolerating the large volume and unpalatable taste of polyethylene glycol solutions.
