Optimal preparation-to-colonoscopy interval in split-dose PEG bowel preparation determines satisfactory bowel preparation quality: an observational prospective study

Seo, Eun Hee; Kim, Tae Oh; Park, Min Jae; Joo, Hee Rin; Heo, Nae–Yun; Park, Jongha; Park, Seung Ha; Yang, Sung Bong; Moon, Young Soo

doi:10.1016/j.gie.2011.09.029

Cited by 132 publications

(117 citation statements)

References 17 publications

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“…This is a factor that is well known to positively influence efficacy rate. 14 Our data also confirmed both adult and pediatric data on the safety of NaPico +MgCit compared with PEG-ELS 11,[15][16][17] and, for the first time in a pediatric population, with 2 low-volume PEG solutions (PEG-CS+bisacodyl and PEGAsc). Indeed, in our series there was no statistically significant difference in the incidence of dehydration or in preand posttreatment laboratory values of kidney and liver function and serum 2 test.…”

Section: Discussionsupporting

confidence: 82%

Bowel Preparations for Colonoscopy: An RCT

et al. 2014

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BACKGROUND: The ideal preparation regimen for pediatric colonoscopy remains elusive, and available preparations continue to represent a challenge for children. The aim of this study was to compare the efficacy, safety, tolerability, and acceptance of 4 methods of bowel cleansing before colonoscopy in children. METHODS: This randomized, investigator-blinded, noninferiority trial enrolled all children aged 2 to 18 years undergoing elective colonoscopy in a referral center for pediatric gastroenterology. Patients were randomly assigned to receive polyethylene glycol (PEG) 4000 with simethicon (PEG-ELS group) or PEG-4000 with citrates and simethicone plus bisacodyl (PEG-CS+Bisacodyl group), or PEG 3350 with ascorbic acid (PEG-Asc group), or sodium picosulfate plus magnesium oxide and citric acid (NaPico+MgCit group). Bowel cleansing was evaluated according to the Boston Bowel Preparation Scale. The primary end point was overall colon cleansing. Tolerability, acceptability, and compliance were also evaluated. RESULTS: Two hundred ninety-nine patients were randomly allocated to the 4 groups. In the per-protocol analysis, PEG-CS+Bisacodyl, PEG-Asc, and NaPico+MgCit were noninferior to PEG-ELS in bowel-cleansing efficacy of both the whole colon (P = .910) and colonic segments. No serious adverse events occurred in any group. Rates of tolerability, acceptability, and compliance were significantly higher in the NaPico+MgCit group. CONCLUSIONS: Low-volume PEG preparations (PEG-CS+Bisacodyl, PEG-Asc) and NaPico+MgCit are noninferior to PEG-ELS in children, representing an attractive alternative to high-volume regimens in clinical practice. Because of the higher tolerability and acceptability profile, NaPico+MgCit would appear as the most suitable regimen for bowel preparation in children.

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Section: Discussionsupporting

confidence: 82%

Bowel Preparations for Colonoscopy: An RCT

et al. 2014

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“…e shorter the delay, the better the cleansing, with the optimum being between 3 to 5 hours [18]. In our group, all patients were examined during the morning.…”

Section: Discussionmentioning

confidence: 99%

A Single or Split Dose Picosulphate/Magnesium Citrate Before Colonoscopy: Comparison Regarding Tolerance and Eficacy with Polyethylene Glycol. A Randomized Trial

Kojecký

Dolina

Kianička

et al. 2014

JGLD

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Background & Aims: To compare the eficacy and tolerance of sodium picosulphate/magnesium citrate(PMC) and polyethylene glycol (PEG) in a single or split dose regimen for colonoscopy bowel preparation.Methods: A prospective, randomized, endoscopist-blinded, multicenter study. The patients were randomly assigned to receive PMC (PMC4/0) or PEG (PEG4/0) in a single dose 4L day before colonoscopy or a split dose 2+2L PMC (PMC2/2) or 3+1L PEG (PEG3/1) one day before and in the morning before the colonoscopy. Each patient was interviewed to determine his/her subjective tolerance of the preparation before the procedure. The quality of bowel cleansing was assessed in a blinded test performed by multiple endoscopists using the Aronchick scale.Results: A total of 600 patients were enrolled, 88.2% were included in the analysis. Satisfactory bowel cleansing (Aronchick score 1 and 2) was signicantly more frequent when a split dose was used irrespective of the solution type (81.6% PMC2/2, 87.3% PEG3/1 vs. 73.0% PEG4/0, p = 0.024). In single dose regimens, PMC performed better than PEG (82.6% vs. 73.0%). Single or split dose PMC preparations were comparable. A PMC based solution was generally better tolerated than PEG regardless of the regimen used (p < 0.001). Nausea was reported mostly after the 4L PEG (32.8%, p < 0.001), incontinence after a split PMC dose (34.4%, p = 0.002), and bloating after the 4L PEG (38.0%, p < 0.001). There was no significant difference in the prevalence of vomiting.Conclusion: Colonic preparation with PMC yields similar results as a split PEG dose, regardless of whether PMC is administered in single or separate doses. PMC is better tolerated than any PEG-based preparation. A single 4L PEG the day before the colonoscopy is less appropriate for bowel cleansing.

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“…Seo et al [28] evaluated 366 consecutive outpatients undergoing colonoscopy using the split preparation; colonoscopies with PC interval 3 to 5 h had the best bowel preparation quality. Matro et al [22] compared the efficacy and tolerability of morning-only PEG to splitdose PEG for afternoon colonoscopy, and found both equivalent with respect to cleansing efficacy and polyp detection.…”

Section: Quality Of Bowel Preparationmentioning

confidence: 99%

Comparison of split-dosingvsnon-split (morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy

Shah

Desai

Samant

et al. 2014

WJGE

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AIM: To compare (using the Ottawa Bowel PreparationScale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the optimal preparation-to-colonoscopy interval. METHODS:Single-centre, prospective, randomized, investigator-blind stud in an academic tertiarycare centre. Two hundred patients requiring elective colonoscopy were assigned to receive one of the two preparation regimens (split vs morning) prior to colonoscopy. Main outcome measurements were bowel preparation quality and patient tolerability. RESULTS:Split-dose regimen resulted in better bowel preparation compared to morning regimen [Ottawa score mean 5.52 (SD 1.23) vs 6.02 (1.34); P = 0.017].On subgroup analysis, for afternoon procedures, both the preparations were equally effective (P = 0.756). There was no difference in tolerability and compliance between the two regimens. CONCLUSION:Overall, previous evening -same morning split-dosing regimen results in better bowel cleansing for colonoscopy compared to morning preparation. For afternoon procedures, both schedules are equally effective; morning preparation may be more convenient to the patient. Key words: Bowel preparation; Colonoscopy; Morning preparation; Split dose preparation; Preparation to colonoscopy interval Core tip: Split bowel reparation compared to single dose morning preparation resulted in a better bowel cleansing using the Ottawa Bowel Preparation Scale. The average score (± SD) using the Ottawa Scale was 6.02 ± 1.34 when morning preparation was given and 5.52 ± 1.23 when split preparation was given (P = 0.017). However, there was no statistical difference in the mean Ottawa score when the procedures were done in the afternoon with either the morning or the split preparation (6.09 vs 5.94, P = 0.756). Hence, AM only dosing is as effective as split dosing for patients scheduled for a colonoscopy in the afternoon.

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Optimal preparation-to-colonoscopy interval in split-dose PEG bowel preparation determines satisfactory bowel preparation quality: an observational prospective study

Cited by 132 publications

References 17 publications

Bowel Preparations for Colonoscopy: An RCT

Bowel Preparations for Colonoscopy: An RCT

A Single or Split Dose Picosulphate/Magnesium Citrate Before Colonoscopy: Comparison Regarding Tolerance and Eficacy with Polyethylene Glycol. A Randomized Trial

Comparison of split-dosingvsnon-split (morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy

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