Prospective, randomized, controlled comparison of the use of polyethylene glycol electrolyte lavage solution in four-liter versus two-liter volumes and pretreatment with either magnesium citrate or bisacodyl for colonoscopy preparation

Sharma, Virender K.; Chockalingham, Siva K.; Ugheoke, Eghierhua A.; Kapur, Ashok; Ling, Phillis H.; Vasudeva, Rajeev; Howden, Colin W.

doi:10.1016/s0016-5107(98)70351-7

Cited by 144 publications

(93 citation statements)

References 13 publications

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“…Sulphate-free PEG (SF-PEG) is more palatable with improved aroma and taste than pure PEG solutions. A reduced-volume (2 L) preparations coupled with irritant laxatives, such as bisacodyl or magnesium citrate [40] , was developed to increase patient compliance and is recognised to be as effective as the standard 4 L PEG preparation [41][42][43] . Aqueous sodium phosphate is a low-volume hyperosmotic solution which contains 48 g (400 mmol) of monobasic sodium phosphate and 18 g (130 mmol) of dibasic sodium phosphate per 100 mL.…”

Section: Bowel Cleansing Agentsmentioning

confidence: 99%

Factors influencing quality of bowel preparation for colonoscopy

Romero

Mahadeva

2013

WJGE

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Recent technological advances in colonoscopy have led to improvements in both image enhancement and procedural performance. However, the utility of these technological advancements remain dependent on the quality of bowel preparation during colonoscopy. Poor bowel preparation has been shown to be associated with lower quality indicators of colonoscopy performance, such as reduced cecal intubation rates, increased patient discomfort and lower adenoma detection. The most popular bowel preparation regimes currently used are based on either Polyethylene glycol-electrolyte, a non-absorbable solution, or aqueous sodium phosphate, a lowvolume hyperosmotic solution. Statements from various international societies and several reviews have suggested that the efficacy of bowel preparation regimes based on both purgatives are similar, although patients' compliance with these regimes may differ somewhat. Many studies have now shown that factors other than the type of bowel preparation regime used, can influence the quality of bowel preparation among adult patients undergoing colonoscopy. These factors can be broadly categorized as either patient-related or procedure-related. Studies from both Asia and the West have identified patient-related factors such as an increased age, male gender, presence of co-morbidity and socioeconomic status of patients to be associated with poor bowel preparation among adults undergoing routine out-patient colonoscopy. Additionally, procedure-related factors such as adherence to bowel preparation instructions, timing of bowel purgative administration and appointment waiting times for colonoscopy are recognized to influence the quality of colon cleansing. Knowledge of these factors should aid clinicians in modifying bowel preparation regimes accordingly, such that the quality of colonoscopy performance and delivery of service to patients can be optimised.

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Section: Bowel Cleansing Agentsmentioning

confidence: 99%

Factors influencing quality of bowel preparation for colonoscopy

Romero

Mahadeva

2013

WJGE

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“…To date, no bowel preparation meets all the requirements though important, advancements have been made with the low-volume [3][4][5][6][7] and split-dose bowel preparations. There is still a need to increase the overall acceptability of bowel preparation for colonoscopy and reduce the burden and impact on productivity and daily living with the ultimate objective to improve the attitude toward colonoscopy within the colon cancer screening programs [8] .…”

Section: Introductionmentioning

confidence: 99%

Same-day 2-L PEG-citrate-simethicone plus bisacodylvssplit 4-L PEG: Bowel cleansing for late-morning colonoscopy

Leone

Tamayo²,

Fiori³

et al. 2013

WJGE

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AIM:To evaluate the efficacy, tolerability, acceptability and feasibility of bisacodyl plus low volume polyethyleneglycol-citrate-simeticone (2-L PEG-CS) taken the same day as compared with conventional split-dose 4-L PEG for late morning colonoscopy. METHODS:Randomised, observer-blind, parallel group, comparative trial carried out in 2 centres. Out patients of both sexes, aged between 18 and 85 years, undergoing colonoscopy for diagnostic investigation, colorectal cancer screening or follow-up were eligible. The PEG-CS group received 3 bisacodyl tablets (4 tablets for patients with constipation) at bedtime and 2-L PEG-CS in the morning starting 5 h before colonoscopy. The control group received a conventional 4-L PEG formulation given as split regimen; the morning dose was taken with the same schedule of the low volume preparation. The Ottawa Bowel Preparation Scale (OBPS) score was used as the main outcome measure. RESULTS:A total of 164 subjects were enrolled and 154 completed the study; 78 in the PEG-CS group and 76 in the split 4-L PEG group. The two groups were comparable at baseline. The OBPS score in the PEG-CS group (3.09 ± 2.40) and in the PEG group (2.39 ± 2.55) were equivalent (difference +0.70; 95%CI: -0.09-1.48). This was confirmed by the rate of successful bowel cleansing in the PEG-CS group (89.7%) and in the PEG group (92.1%) (difference -2.4%; 95%CI: -11.40-6.70). PEG-CS was superior in terms of mucosa visibility compared to PEG (85.7% vs 72.4%, P = 0.042). There were no significant differences in caecum intubation rate, time to reach the caecum and withdrawal time between the two groups. The adenoma detection rate was similar (PEG-CS 43.6% vs PEG 44.7%). No serious adverse events occurred. No difference was found in tolerability of the bowel preparations. Compliance was equal in both groups: more than 90% of subjects drunk the whole solution. Willingness to repeat the same bowel preparations was about 90% for both regimes. CONCLUSION:Same-day PEG-CS is feasible, effective as split-dose 4-L PEG for late morning colonoscopy and does not interfere with work and daily activities the day before colonoscopy. Key words: Bowel preparation; Polyethyleneglycol; Simethicone; Ottawa Bowel Preparation Scale; Colonoscopy Core tip: The timing of bowel preparation is fundamental for high quality colonoscopy and also for patient satisfaction. Split-dose preparation improves the rate of adequate cleansing and patient compliance. This study shows that the same-day low volume polyethyleneglycol-citrate-simeticone (PEG-CS) plus bisacodyl tablets is feasible, and as effective as split 4-L PEG. The low volume bowel preparation taken the same day of the exam may be an attractive option for late morning September 16, 2013|Volume 5|Issue 9|

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“…Consequently, recent investigations have focused on lowering the amount of PEG-EL to avoid inadequate precolonoscopic preparation, which is seen in almost 20% of patients undergoing colonoscopy [7,8,9,10]. Prokinetic, spasmolytic and laxative agents have all been used to attempt to improve the effectiveness and tolerance of colonoscopic preparation regimes [10,11,12,13]. However, none of them proved to be an ideal combination.In one study, 2 liters of PEG-EL was shown to have similar effectiveness and patient tolerance to 90 ml of NaP [14], and in another study, combining ascorbic acid with PEG led to better tolerability and comparable effectiveness with PEG-EL [7,15].…”

Section: Introductionmentioning

confidence: 99%

Adding Pineapple Juice to a Polyethylene Glycol-Based Bowel Cleansing Regime Improved the Quality of Colon Cleaning

et al. 2013

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Background/Aims: An unsuccessful colonoscopy procedure is often related toinadequate bowel cleansing. It is difficult for patients to finish the whole 4 liters of polyethylene glycol-electrolyte lavage (PEG-EL) because of its salty taste and the large quantity. Pineapple juice has been shown to be an effective agent in the dissolution of undigested food in the stomach. This study assessed the effectiveness of both 2 and 4 liters of PEG-EL in precolonoscopic bowel cleansing and the quality of colonoscopic cleaning by adding 1 liter of pineapple juice to a reduced-volume PEG-based regime. Methods: The patients were chosen from those undergoing a colonoscopic procedure. A total of 126 patients were randomized into 3 groups receiving 3 different PEG-EL (Golytely®) regimes, i.e. 4 liters of PEG-EL (group 1, n = 44), 2 liters of PEG-EL (group 2, n = 39) or 2 liters of PEG-EL with 1 liter of pineapple juice (Dimes® 100%; group 3, n = 43). Results: Both the 4- and 2-liter PEG-EL regimes resulted in similar bowel cleansing scores in all parts of the colonic segments.However, adding 1 liter of pineapple juice to the reduced-volume PEG-EL regime improved the quality of the cleansing on the right side of the colon and in the transverse colon. Adequate bowel cleansing was achieved in 68.1% of the patients in group 1, 63.9% in group 2 and 80% in group 3 (the lowest score in one of the segments). On the other hand, the tolerability of the regimes was similar in all 3 groups (p = 0.509). Conclusions: Reduced PEG-EL (2 rather than 4 liters) may be sufficient for precolonoscopic bowel cleansing in the Turkish population. Administration of pineapple juice in the reduced-dose preparation regime may improve the quality of the bowel cleaning.

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Prospective, randomized, controlled comparison of the use of polyethylene glycol electrolyte lavage solution in four-liter versus two-liter volumes and pretreatment with either magnesium citrate or bisacodyl for colonoscopy preparation

Cited by 144 publications

References 13 publications

Factors influencing quality of bowel preparation for colonoscopy

Factors influencing quality of bowel preparation for colonoscopy

Same-day 2-L PEG-citrate-simethicone plus bisacodylvssplit 4-L PEG: Bowel cleansing for late-morning colonoscopy

Adding Pineapple Juice to a Polyethylene Glycol-Based Bowel Cleansing Regime Improved the Quality of Colon Cleaning

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