Original Articles
A randomized single-blind trial of whole versus split-dose polyethylene glycol-electrolyte solution for colonoscopy preparation,☆☆

Presented as an oral presentation at the United European Gastroenterology Week, October 19-23, 2002 in Geneva, Switzerland (Endoscopy 2002;34(Suppl II):A36).
https://doi.org/10.1067/mge.2003.318Get rights and content

Abstract

Background: Colonoscopy preparation regimens are often poorly tolerated because they require use of large-volume bowel preparation solution and diet restrictions for adequate cleansing. This study evaluated the efficacy and tolerability of a split-dose polyethylene glycol-electrolyte solution plus bisacodyl and a regular diet. Methods: A total of 187 patients (104 men, 83 women; age range 18-91 years) were randomly assigned to receive either 3 L of polyethylene glycol-electrolyte solution (n = 96; Group A) with a liquid diet on the day before colonoscopy, or 2 L of polyethylene glycol-electrolyte solution, one tablet of bisacodyl, and a minimally restricted diet on the day before colonoscopy, and then 1 L of the same solution on the day of colonoscopy (n = 91; Group B). Acceptability, adverse events, and willingness to retake the preparation were assessed by questionnaire. The quality of the preparation was graded by an endoscopist, blinded to the type of preparation, by using a previously described scale (excellent to poor). Results: There were 96 patients in Group A and 91 in Group B. Colon cleansing was significantly better in Group B with regard to the overall quality of the preparation (p lt; 0.05). Compliance was significantly higher in Group B as evidenced by the lower number of patients who discontinued the preparation (4 vs. 15; p = 0.02) because of side effects such as nausea or vomiting. The degree of discomfort, adverse events, and willingness to retake the preparation were not significantly different between the groups. Conclusions: Colonic preparation with split-dose polyethylene glycol-electrolyte provided better quality colon cleansing and higher compliance, with less dietary restrictions, than preparation with whole-dose polyethylene glycol-electrolyte. (Gastrointest Endosc 2003;58:36-40.)

Section snippets

Patients

Ambulatory patients seen on an outpatient basis and scheduled for an elective colonoscopy were enrolled in the study. Exclusion criteria were the following: age under 18 years; the presence of serious conditions such as severe cardiac, renal, or metabolic diseases; active alcoholism, drug addiction, or major psychiatric illness; known allergy to PEG or bisacodyl; and refusal to consent to the study. The study was conducted between September 1, 2001, and April 30, 2002. After obtaining informed

Results

One hundred eighty-seven patients (83 women, 104 men; mean age, 56 years; range 18-91 years) were recruited for the study, 96 randomized to Group A and 91 to Group B (Table 2).

. Demographic data, indications for colonoscopy and history of surgery

Empty CellGroup A (n = 96) n (%)Group B (n = 91) n (%)p Value
Age, range (y)18-9121-84
Age, mean (y) (SD)56 (14)55 (13)
Gender, F:M (ratio)1.1:11:1.80.04
Indication
 Anemia9 (9%)2 (2%)0.08
 Abdominal pain22 (23%)21 (23%)1.0
 Rectal bleeding19 (20%)25 (28%)0.3
 Follow-up

Discussion

Colonoscopy is the method of choice for evaluation of the large bowel and terminal ileum for both diagnostic and therapeutic purposes. The difficulty and duration of the procedure depend in part on the adequacy of bowel cleansing. For the last two decades, ingestion of the PEG-electrolyte solution has been the standard method for preparing patients for colonoscopy, with excellent bowel preparation being achieved by a large number of patients with no significant effects on the extra- and

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  • Evaluation of Clensia<sup>®</sup>, a new low-volume PEG bowel preparation in colonoscopy: Multicentre randomized controlled trial versus 4L PEG

    2017, Digestive and Liver Disease
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    On this basis, the development of new regimens (full or split) and formulations for bowel cleansing with a higher degree of tolerability is desirable. Some clinical trials have shown how split-dose PEG solution results in a marked increase in tolerability which improves overall bowel preparation quality [15–18]. This effect was also observed in our study: the rate of successful bowel cleansing were significantly higher with the split-dose regimen than with the full dose the day before for both low and high volume bowel preparations.

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Reprint requests: Ala I. Sharara, MD, Box 16-B, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh 110 72020, Beirut, Lebanon.

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0016-5107/2003/$30.00 + 0

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