Original articleClinical endoscopyEffective bowel cleansing before colonoscopy: a randomized study of split-dosage versus non-split dosage regimens of high-volume versus low-volume polyethylene glycol solutions
Section snippets
Design of the study
This was a single-blind, active control, prospective, randomized study of adult patients undergoing routine elective colonoscopy. All patients with an appropriate indication to colonoscopy were considered eligible. Exclusion criteria were pregnant or lactating women, age less than 18 years, significant gastroparesis or gastric outlet obstruction or ileus, known or suspected bowel obstruction or perforation, phenylketonuria or glucose-6-phosphate dehydrogenase deficiency, severe chronic renal
Results
Study participant allocation is recorded in Figure 1. Of the 926 patients assessed for eligibility, 31 were excluded for contraindications (9 for severe chronic renal failure, 6 for age <18 years, 2 for dementia, 6 for cerebrovascular disease, and 8 for severe hypertension). A total of 895 patients were included and randomized to the split-dosage schedule (N = 448) or to the non-split-dosage schedule (N = 447). Nine patients had a major protocol deviation (2 patients had a double dose of PEG
Discussion
The results of our study add to the generalizability of the finding that the low-volume PEG plus ascorbic acid solution is as effective as the standard 4 L PEG solution, with equivalent degrees of colon cleansing.18, 20 Efficacy was coupled with an excellent safety profile. Adverse events were infrequent and of minor clinical relevance. Compliance to complete preparation was surprisingly high in our study, with no difference among volumes or intake schedules. Possible explanation resides in the
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Cited by (150)
The Bowel CLEANsing National Initiative: High-Volume Split-Dose Vs Low-Volume Split-Dose Polyethylene Glycol Preparations: A Randomized Controlled Trial
2022, Clinical Gastroenterology and HepatologyEfficacy and Tolerability of High- vs Low-Volume Split-Dose Bowel Cleansing Regimens for Colonoscopy: A Systematic Review and Meta-analysis
2020, Clinical Gastroenterology and HepatologyPreparation for colonoscopy: Recommendations by an expert panel in Italy
2018, Digestive and Liver DiseasePractice Guidelines for Preoperative Fasting: Reply
2023, AnesthesiologyGood bowel preparation for a colonoscopy
2023, Colonoscopy: Screening, Procedures and Preparation
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 392
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