Polyethylene glycol versus split high‐dose senna for bowel preparation: A comparative prospective randomized study

Abstract

Background and Aim The aim of this study was to compare the quality and tolerability of bowel preparation using split high‐doses of sennosides versus split‐dose polyethylene glycol (PEG). Methods In this prospective, randomized, and endoscopist‐blinded study, 474 outpatients were included and randomly assigned to two groups: Group 1 was comprised of 237 patients receiving split high‐dose (1000 mg) sennoside solutions, and group 2 included 237 patients receiving 4 L of PEG. The efficacy of the preparations was evaluated on the Boston Bowel Preparation Scale (BBPS), and compliance and adverse effects were recorded. Results The quality of colon cleansing and the ease of bowel preparation were significantly better in the senna group; the mean of total BBPS scores was 7.35 in the senna group and 6.57 in the PEG group, cleansing was adequate (BBPS score ≥ 6) in 89.9% of patients taking senna, and 73.8% in the PEG group (P = 0.001). The rates of vomiting in the senna and PEG groups were 12.7% and 29.5%, nausea rates were 28.7% and 43.9%, and abdominal pain rates were 70.9% and 43%, respectively (P < 0.001). Cecal intubation rates in the senna and PEG groups were 95.4% and 86.1% (P = 0.001), and the cecal intubation times were 6.73 ± 2.84 and 5.34 ± 5.98 min, respectively (P = 0.001). Conclusions Split high‐dose senna is more effective than split‐dose PEG in terms of bowel preparation quality and patient compliance. The patients who received senna had significantly less vomiting and nausea but significantly more abdominal pain. Thus, senna may be used as an alternative to PEG for bowel preparation.

Low volume polyethylene glycol combined with senna versus high volume polyethylene glycol, which regimen is better for bowel preparation for colonoscopy? A randomized, controlled, and single‐blinded trial

“…while results of this study about improvement in abdominal cramps are not consistent with those two studies. 31 , 32 According to our data, the PEG‐senna regimen can emerge as a reasonable approach for colon preparation before elective colonoscopy since it can reduce the rate of overall adverse events and improve patient overall acceptance along with the fact that its efficiency in quality of preparation is at least noninferior to the standard regimen. Our study was performed in only one clinical establishment and larger studies in more than one center and region are required to confirm our findings.…”

Safety and efficacy comparison of polyethylene glycol, hemp seed oil, and 5% sugar brine for bowel preparation in older patients: study protocol for a randomized controlled trial

“…According to the results of previous studies, when using 3 L PEG for bowel preparation, the qualified rate of bowel preparation was 80%. PEG was accepted as the standard preparation, and the aforementioned percentage was taken as a reference [ 18 , 20 , 37 , 38 ]. Assuming the qualified rate of bowel preparation in this study is 85%, the alpha level was set to 0.05.…”

A Safety and Efficacy Comparison of polyethylene glycol, hemp seed oil, and 5% sugar brine for bowel preparation in older adults patients: study protocol for a randomized controlled trial

“…According to the results of previous studies, when using 3L PEG for bowel preparation, the quali ed rate of bowel preparation is 80%. PEG was accepted as the standard preparation, and this percentage was taken as a reference [18,20,37,38]. Assuming the quali ed rate of bowel preparation in this study is 85%, the alpha level was set to 0.05.…”

“…Recently, many clinical studies on bowel preparation are being conducted with the aim of improving the quality of bowel preparation and patients' tolerance. Examples of such studies include studies on the application of ascorbic acid, senna, and sodium phosphatases [18][19][20][21]. However, many trials have not achieved the expected results of bowel preparation.…”