Polyethylene glycol combined with linaclotide is an effective and well-tolerated bowel preparation regimen for colonoscopy: an endoscopist-blinded, randomized, controlled trial

Zhang, Menghan; Zou, Wenlu; Xu, Chao; Jia, Ruzhen; Liu, Keke; Xu, Qianqian; Xu, Hongwei

doi:10.1097/meg.0000000000002184

Cited by 13 publications

(9 citation statements)

References 38 publications

(61 reference statements)

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“…Sixty-eight articles were reviewed by full text. Overall, 18 articles[ 11 - 28 ] comparing bowel preparation with SSDs vs SpDs PEG were included in this analysis. Figure 1 shows a flowchart of studies from initial results of publication searches to final inclusion or exclusion.…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 summarizes the characteristics of the 18 included studies ( n = 5464), which consisted of 2793 patients who received SSDs and 2671 patients who received the SpDs regimen. Nine trials evaluated low-volume (2 L) SSD PEG with adjuvant laxative use vs large-volume(≥ 3 L) SpDs PEG[ 11 , 12 , 22 - 28 ], four trials compared 4 L SSD PEG vs 4 L SpDs PEG[ 13 , 14 , 19 , 20 ], and six trials compared 2 L SSD PEG vs (≥ 3 L) SpDs PEG[ 11 , 15 - 18 , 21 ]. Interestingly, in a study by Zhang et al [ 11 ], patients were assigned to three groups: 2 L SSD PEG, 2 L SSD PEG with adjuvant laxative (linaclotide) and 4 L SpDs PEG.…”

Section: Resultsmentioning

confidence: 99%

“…Bowel cleanliness was evaluated either with BBPS[ 11 , 12 , 14 , 15 , 18 , 23 - 27 ] or OBPS[ 13 , 16 , 17 , 19 - 22 , 28 ]. An adequate bowel preparation was defined as a total BBPS score ≥ 6 with all colon segments scores ≥ 2, or a total OBPS score < 5 (including score < 7 by De Leone, score ≤ 3 by Cesaro) or all colon segment OBPS score < 2.…”

Section: Resultsmentioning

confidence: 99%

“…An adequate bowel preparation was defined as a total BBPS score ≥ 6 with all colon segments scores ≥ 2, or a total OBPS score < 5 (including score < 7 by De Leone, score ≤ 3 by Cesaro) or all colon segment OBPS score < 2. Diet restriction was mentioned in 16 trials and consisted of low residual diet/low-fiber foods[ 11 , 14 - 16 , 20 - 25 , 27 - 28 ] or clear liquid diet[ 13 , 15 , 17 , 19 , 26 , 28 ] before colonoscopy. Colonoscopy was performed with optimal preparation-to-colonoscopy (PC) interval time in only 6 trials[ 11 , 12 , 15 , 16 , 21 , 24 ], while 9 trials did not mention the PC interval[ 13 , 14 , 20 , 22 , 23 , 25 - 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…Diet restriction was mentioned in 16 trials and consisted of low residual diet/low-fiber foods[ 11 , 14 - 16 , 20 - 25 , 27 - 28 ] or clear liquid diet[ 13 , 15 , 17 , 19 , 26 , 28 ] before colonoscopy. Colonoscopy was performed with optimal preparation-to-colonoscopy (PC) interval time in only 6 trials[ 11 , 12 , 15 , 16 , 21 , 24 ], while 9 trials did not mention the PC interval[ 13 , 14 , 20 , 22 , 23 , 25 - 28 ].…”

Section: Resultsmentioning

confidence: 99%

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Same-day single-dose vs large-volume split-dose regimens of polyethylene glycol for bowel preparation: A systematic review and meta-analysis

Hui¹,

Zheng²,

Fang³

et al. 2022

WJCC

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BACKGROUND Split-dose regimens (SpDs) of 4 L of polyethylene glycol (PEG) have been established as the “gold standard” for bowel preparation; however, its use is limited by the large volumes of fluids required and sleep disturbance associated with night doses. Meanwhile, the same-day single-dose regimens (SSDs) of PEG has been recommended as an alternative; however, its superiority compared to other regimens is a matter of debate. AIM To compare the efficacy and tolerability between SSDs and large-volume SpDs PEG for bowel preparation. METHODS We searched MEDLINE/PubMed, the Cochrane Library, RCA, EMBASE and Science Citation Index Expanded for randomized trials comparing (2 L/4 L) SSDs to large-volume (4 L/3 L) SpDs PEG-based regimens, regardless of adjuvant laxative use. The pooled analysis of relative risk ratio and mean difference was calculated for bowel cleanliness, sleep disturbance, willingness to repeat the procedure using the same preparation and adverse effects. A random effects model or fixed-effects model was chosen based on heterogeneity analysis among studies. RESULTS A total of 18 studies were included. There was no statistically significant difference of adequate bowel preparation (relative risk = 0.97; 95%CI: 0.92-1.02) (14 trials), right colon Boston Bowel Preparation Scale (mean difference = 0.00; 95%CI: -0.04, 0.03) (9 trials) and right colon Ottawa Bowel Preparation Scale (mean difference = 0.04; 95%CI: -0.27, 0.34) (5 trials) between (2 L/4 L) SSDs and large-volume (4 L/3 L) SpDs, regardless of adjuvant laxative use. The pooled analysis favored the use of SSDs with less sleep disturbance (relative risk = 0.52; 95%CI: 0.40, 0.68) and lower incidence of abdominal pain (relative risk = 0.75; 95%CI: 0.62, 0.90). During subgroup analysis, patients that received low-volume (2 L) SSDs showed more willingness to repeat the procedure using the same preparation than SpDs ( P < 0.05). No significant difference in adverse effects, including nausea, vomiting and bloating, was found between the two arms ( P > 0.05). CONCLUSION Regardless of adjuvant laxative use, the (2 L/4 L) SSD PEG-based arm was considered equal or better than the large-volume (≥ 3 L) SpDs PEG regimen in terms of bowel cleanliness and tolerability. Patients that received low-volume (2 L) SSDs showed more willingness to repeat the procedure using the same preparation due to the low-volume fluid requirement and less sleep disturbance.

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Section: Resultsmentioning

confidence: 99%