Comparison between Conventional 4 L Polyethylene Glycol and Combination of 2 L Polyethylene Glycol and Sodium Phosphate Solution as Colonoscopy Preparation

Lee, Jung Won; Kim, Na Young; Hyo, Byung; Lee, Byoung Hwan; Hwang, Tae Jun; Jeong, Yu Jeong; Choi, Tae Hyuck; Kim, Hee Sup; Myung, Hyung Joon; Kim, Jang Eon; Jang, Jeong Hun; Kim, Yeo Myeong; Kim, Jong Yeop; Park, Hyun Kyung; Suh, Seung Chul; Seo, Pyoung Ju; Song, Joon Chang; Shin, Cheol Min; Eum, Young Ook; Kwon, Jung Hyeok; Kim, Jin Joo; Song, Byeong Jun; Park, Young Soo; Lee, Dong Hoon

doi:10.4166/kjg.2010.56.5.299

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…Whether different bowel preparation drugs show different effectiveness remains controversial. Previous reports have suggested that bowel preparation is associated with not only drugs, but also drug compliance and fiber diet education [35,36]. Our study showed that there was a sex difference in bowel preparation status using bowel preparation drugs.…”

Section: Discussionsupporting

confidence: 55%

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Sex difference in bowel preparation quality and colonoscopy time

Hwang

Shin

Kim

et al. 2021

Korean J Intern Med

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Background/Aims: The length of colon is known to be longer in females than in males. In addition, the morphology of colon cancer is different between males and females. The aim of this study was to investigate sex differences in Boston bowel preparation score (BBPS) and colonoscopy insertion time. Methods: This study retrospectively analyzed medical records and colonoscopy readings of subjects who underwent colonoscopy at Seoul National University Bundang Hospital from March 2015 to April 2018. BPPS was used to evaluate the degree of colon cleanness before colonoscopy. Statistical analysis was performed to compare demographic, clinical, and outcome variables between two groups. Results: The study group consisted of a total of 12,561 patients (6,148 females and 6,413 males). Mean age was 57.8 ± 13.5 years for females and 57.5 ± 13.8 years for males (p = 0.695). Females showed better bowel preparation than males (mean total score: 7.4 ± 1.8 vs. 7.2 ± 1.9, p = 0.001; total score ≥ 6: 5,340 [86.9%] vs. 5,437 [84.8%], p = 0.001; BBPS ≥ 2 for all segments: 5,048 [82.1%] vs. 5,097 [79.5%], p < 0.001). However, cecal intubation time (8.3 ± 6.2 minutes vs. 6.2 ± 6.1 minutes, p < 0.001) and withdrawal time (7.9 ± 3.5 minutes vs. 7.4 ± 3.1 minutes, p < 0.001) were longer in males. Conclusions: There were sex differences in BBPS, cecal intubation time, and withdrawal time for subjects undergoing colonoscopy.

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Section: Discussionsupporting

confidence: 55%

“…We analyzed various guidelines for adequate bowel preparation and found that females showed bet- ter bowel preparation results. It is known that bowel preparation is influenced by various factors [11][12][13]35,36]. Our study showed that sex factor could influence bowel preparation based on a large cohort database.…”

Section: Discussionmentioning

confidence: 58%

Sex difference in bowel preparation quality and colonoscopy time

Hwang

Shin

Kim

et al. 2021

Korean J Intern Med

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“…Another study published in Korea investigated the efficacy and safety of 2 L PEG using two doses of 45 mL NaP compared with 4 L PEG in a nonrandom manner 16. However, our present study is the first large prospective randomized trial comparing 2 L PEG with a single dose of 45 mL NaP and 4 L PEG for bowel cleansing before colonoscopy.…”

Section: Discussionmentioning

confidence: 89%

A Comparison of 2 L of Polyethylene Glycol and 45 mL of Sodium Phosphate versus 4 L of Polyethylene Glycol for Bowel Cleansing: A Prospective Randomized Trial

Bae¹,

Kim²,

Eum³

et al. 2013

Gut Liver

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Background/AimsPolyethylene glycol (PEG)-based gut lavage solutions are safe and effective, but require the intake of large volumes of fluid. The use of 2 L PEG plus 45 mL sodium phosphate (PEG2 plus NaP) was compared with 4 L PEG (PEG4) for bowel cleansing before colonoscopy.MethodsPatients were randomized to the PEG2 plus NaP group or PEG4 group between January 1, 2009 and March 31, 2010. One hundred and thirty patients were included in the PEG2 plus NaP group, and 141 patients in the PEG4 group.ResultsThe qualities of the bowel preparation, based on the Ottawa scale were not significantly different between the groups (4.8±2.25 for the PEG2 plus NaP group vs. 5.11±2.26 for the PEG4). In addition, there were no significant differences in side effects. Laboratory findings after bowel preparation, including electrolyte, phosphorus and creatinine levels, were within the normal ranges in both groups.ConclusionsPEG2 plus NaP provides good cleansing that is similar to PEG4, but with a lower volume. However, because PEG2 plus NaP can cause serious side effects such as calcium deposition in the kidneys (i.e., nephrocalcinosis), this solution might be considered for the outpatients who cannot tolerate PEG4.

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“…13,28–30 To date, however, few studies have investigated combinations of 2 different bowel-cleansing agents. 22,31 Our hypothesis was that the combination of 2 different regimens at half dosage could augment the strength of each regimen while also reducing side effects. In this prospective, randomized, single-blind, phase II study, we evaluated the efficacy, tolerability, and side effects of 4 different combination regimens: PMC-PEG-DP, PMC-PEG-SD, PMC-NaP-DP, and PMC-NaP-SD.…”

Section: Discussionmentioning

confidence: 99%

“…22,23 Combination regimens of different preparations at reduced volumes could benefit patients by enhancing the quality of bowel cleansing and improving compliance. However, there has been limited evidence regarding the utility of combined regimens and their clinical use for bowel cleansing.…”

Section: Introductionmentioning

confidence: 99%

Phase II Randomized Controlled Trial of Combined Oral laxatives Medication for BOwel PREParation (COMBO-PREP study)

et al. 2016

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The combination of different laxatives at reduced volumes may benefit patients by enhancing efficacy for bowel cleansing and increasing tolerability. However, evidence regarding combined preparations is scarce. This study evaluated whether the combined preparations are associated with enhanced efficacy and tolerability.This randomized phase II study had a single-blind, parallel-arm design.Between December 2013 and September 2014, consecutive patients aged between 20 and 65 years and who required diagnostic colonoscopies were considered for inclusion. Patients were randomly allocated into 4 arms: sodium picosulfate and magnesium citrate (PMC) and polyethylene glycol (PEG) with ascorbic acid in a day-prior (PMC-PEG-DP), PMC and oral sodium phosphate (NaP) in a day-prior (PMC-NaP-DP), PMC and PEG with ascorbic acid in a split-dose (PMC-PEG-SD), and PMC and oral NaP in a split-dose (PMC-NaP-SD). Primary endpoint was the Aronchick scale, and Ottawa scale results by colon segment, patients’ adverse gastrointestinal symptoms, and willingness to reuse the same agents were also recorded. Successful bowel preparation was defined as an “excellent” or “good” score on the Aronchick scale.A total of 236 patients were randomized and 229 patients received the planned colonoscopy. The rates of successful bowel preparation in the PMC-PEG-DP, PMC-NaP-DP, PMC-PEG-SD, and PMC-NaP-SD were 82.5%, 64.4%, 100%, and 100%, respectively. Excluding the failed PMC-NaP-DP group, all groups showed satisfactory rates of successful bowel preparation, and the mean Ottawa scores were significantly better in the PMC-PEG-SD and PMC-NaP-SD groups than in the PMC-PEG-DP group (P < 0.0001). The PMC-PEG-DP, PMC-NaP-DP, PMC-PEG-SD, and PMC-NaP-SD groups were similar in terms of rates of adverse gastrointestinal symptoms reported on a 5-point scale (P = 0.40) and willingness to reuse the same combined preparations (P = 0.55).PMC-PEG in a day-prior or split-dose and PMC-NaP in a split-dose were efficient and tolerable bowel preparations for colonoscopy.

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Comparison between Conventional 4 L Polyethylene Glycol and Combination of 2 L Polyethylene Glycol and Sodium Phosphate Solution as Colonoscopy Preparation

Abstract: PEG 2 L with NaP 90 mL method seems to be more effective bowel preparation than PEG 4 L method.

Cited by 7 publications

References 18 publications

Sex difference in bowel preparation quality and colonoscopy time

Sex difference in bowel preparation quality and colonoscopy time

A Comparison of 2 L of Polyethylene Glycol and 45 mL of Sodium Phosphate versus 4 L of Polyethylene Glycol for Bowel Cleansing: A Prospective Randomized Trial

Phase II Randomized Controlled Trial of Combined Oral laxatives Medication for BOwel PREParation (COMBO-PREP study)

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