Split-dose bowel preparation for colonoscopy and residual gastric fluid volume: an observational study

Impact of Bowel Preparation with Low-Volume (2-Liter) and Intermediate-Volume (3-Liter) Polyethylene Glycol on Colonoscopy Quality: A Prospective Observational Study

“…A recent meta-analysis comparing previousday and split-dose PEG bowel preparations also demonstrated greater cleansing quality for the split-dosing regimen [10] . The residual gastric volume with split-dose or same-day PEG using a 3-L or 4-L regimen has been shown to be minimal in one complete paper and 2 abstracts [36][37][38] .…”

Guidelines for an Optimum Screening Colonoscopy

“…The risk of aspiration is increased in deep sedation, since patients lose protective airway reflexes. As stated above, the average residual gastric volume in patients who have undergone split-dose bowel preparations is not different than those who have received preparation entirely the evening before [32]. However, average residual volume is different than the range.…”

“…In this regard, the administration of clear liquids up until 2 h prior to performing colonoscopy is allowed by American Society of Anesthesiology guidelines [31]. In addition, studies of gastric residuals in patients who had undergone split dosing show that they are no different than those who have undergone evening before dosing [32]. A second concern is regarding patient inconvenience with either getting up in the middle of the night to take the second half of the preparation (if scheduled for an early morning appointment) or of an increased risk of having to stop at a bathroom while in transit from home to the endoscopy unit.…”

A randomized trial to compare the efficacy and tolerability of sodium picosulfate-magnesium citrate solution vs. 4 L polyethylene glycol solution as a bowel preparation for colonoscopy

“…However, it has been shown that residual gastric fluid and pH are independent of the clear liquid fasting period [20,21]. Also, Huffman M. et al have shown that residual gastric fluid volume of patients undergoing same-day elective gastroscopy and colonoscopy after a split-dosing regimen of oral sodium phosphate or PEG was not significantly different to that obtained after a previous-day regimen with the same bowel evacuants [22]. Based on this evidence, current American and European Anaesthesiology Guidelines recommend 2-to 3-h fasting period when only clear liquids are ingested before elective procedures [23,24].…”