Effectiveness of concomitant use of green tea and polyethylene glycol in bowel preparation for colonoscopy: a randomized controlled study

Abstract

Background: Polyethylene glycol solution (PEG) is widely used for bowel preparation prior to colonoscopies. However, patients often exhibited adverse events as nausea, vomit and distention due to its uncomfortable tastes and potential side affects. This study aimed to evaluate the effectiveness and safety of concomitant use of green tea (GT) with PEG in bowel preparation prior to colonoscopy. Methods: This was a prospective, randomized controlled study. It was conducted at an outpatient setting of colorectal surgery in a tertiary hospital. Patients aged 18 through 80 who were scheduled to undergo colonoscopy between August 2015 and February 2016 were randomly assigned into two groups, admitting either 2 L-PEG solutions with 1 L GT liquids or 2 L-PEG solutions only for bowel preparation. Admitted doses of PEG solutions, taste evaluation, adverse reactions (nausea and vomiting, distention and abdominal pain) were investigated by questionnaires. The bowel cleanliness of each patient was evaluated according to the Aronchick indicators. Results: A total of 116 patients were enrolled in this study (PEG+GT 59, PEG 57). Full compliances were achieved in 93.2% patients of group PEG+GT and 59.6% of group PEG (p < 0.001). Mean Aronchick scale between two groups were 2.0 ± 0.9 versus 2.2 ± 0.7 respectively (PEG+GT vs PEG, p = 0.296). Rates of adverse events as nausea and vomiting, abdominal pain in bowel preparation were significantly different between two groups (55.9% vs 77.2%, p = 0.015 and 13.6% vs 33.3%, p = 0.012). Patients in group PEG+GT who have probabilities to receive repeating colonoscopy had a higher willingness to accept PEG+GT again for bowel preparation, compared with PEG group (94.9% vs 57.9%, p < 0.001). Conclusions: Concomitant use of green tea and polyethylene glycol may effectively reduce incidence of adverse events, increase compliances, with comparable bowel cleanliness in bowel preparation. Trial registration: This trial was retrospectively registered on Feb 1st, 2019 (ChiCTR1900021178).

Effect of Inadequate Bowel Preparation on Urgent Colonoscopy in Patients with Post-Polypectomy Bleeding (PPB): A Descriptive Study

“…The usual bowel preparation process requires oral polyethylene glycol electrolyte solution or nasogastric tube irrigation, but because of the aversive taste, patients are highly prone to nausea and vomiting in the process; additionally, the preparation takes longer than an enema or irrigation [14] . Nasogastric tube insertion is one of the most uncomfortable bedside procedures, and the patient's score of discomfort is similar to that of fracture reduction or abscess drainage [15] .…”

Colon Bowel Preparation in the Era of Artificial Intelligence: Is There Potential for Enhancing Colon Bowel Cleansing?

“…Contradictory results have been found in terms of bowel cleansing [47,48]. Some beverages, either as bowel prep diluents, ingested during the pause interval of drinking the preparation, kept in the mouth before bowel preparation ingestion, or drunk after bowel cleansing, were tested [49][50][51]. In RCTs, Coca Cola used as a diluent has resulted in an improvement in the flavor, a shorter time to drink the bowel solution, increased willingness to repeat the same bowel preparation, and an increased quality of bowel cleansing during the colonoscopy [51].…”

“…In RCTs, Coca Cola used as a diluent has resulted in an improvement in the flavor, a shorter time to drink the bowel solution, increased willingness to repeat the same bowel preparation, and an increased quality of bowel cleansing during the colonoscopy [51]. Although other beverages have improved patient satisfaction and decreased side effects, they did not improve bowel cleansing [49,50]. A recent meta-analysis tested whether the use of adjuvants for improving palatability improved patient experience and increased cleansing quality.…”

Novel frontiers of agents for bowel cleansing for colonoscopy

“…A prospective, randomized controlled recent study of Hao et al [ 97 ] aimed to evaluate the effectiveness and safety of concomitant use of green tea (GT) with 2 L PEG in BP for colonoscopy. Adding GT increased the compliance, reduced adverse events with comparable bowel cleanliness in BP.…”