Background: This study aimed to compare the bowel cleansing efficacy, adverse reactions, and patient compliance of two low-volume bowel preparation regimens, sodium picosulfate (PICO) and 2L polyethylene glycol (2L PEG), in a "real-world" setting.
Methods: This single-center, observational trial was conducted at the Gastrointestinal Endoscopy Center of The Third People's Hospital of Chengdu between May and October 2023. Patients undergoing colonoscopy were enrolled, with the primary outcome being the rate of adequate bowel cleansing, as assessed by the Boston Bowel Preparation Scale (BBPS). Secondary outcomes included polyp detection rate, adverse reactions, and patient compliance.
Results: A total of 5423 patients were included, divided into the PICO group (n=739) and the 2L PEG group (n=4684) based on the bowel preparation regimen used. Both groups achieved an adequate bowel cleansing rate exceeding 90% (92.2% vs. 91.3%, P=0.437), with comparable polyp detection rates (42.2% vs. 45.5%, P=0.096) and high willingness to repeat the procedure (99.2% vs. 99%, P=0.588). Notably, total colon and right colon cleansing were more effective in the PICO group compared to the 2L PEG group [(6.90 ± 1.19) vs. (6.81 ± 1.14), P=0.016; (2.15 ± 0.53) vs. (2.11 ± 0.51), P=0.005]. Adverse reactions differed between the groups, with the PICO group experiencing less nausea (5.7% vs. 11.7%, P<0.001) but more sleep disturbances (24.5% vs. 14.6%, P<0.001).
Conclusion: In this real-world study, both PICO and 2L PEG regimens achieved adequate bowel preparation and comparable polyp detection rates. Despite differing adverse reaction profiles more nausea in the 2L PEG group and more sleep disturbances in the PICO group nearly all patients expressed willingness to repeat the same regimen. Thus, both PICO and 2L PEG are safe and effective options for bowel cleansing in the Chinese population.
