Split-dose menthol-enhanced PEG<i>vs</i>PEG-ascorbic acid for colonoscopy preparation

Sharara, Ala I.; Harb, Ali H.; Sarkis, Fayez; Chalhoub, Jean M.; Badreddine, Rami J.; Mourad, Fadi H.; Othman, Mahmoud; Masri, Omar

doi:10.3748/wjg.v21.i6.1938

Cited by 9 publications

(2 citation statements)

References 33 publications

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“…Of these, 17 articles fulfilled the inclusion criteria and were finally included in the systematic review. [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Studies characteristics are briefly reported in Table 1. All studies were published between 2008 and 2019.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Efficacy and Tolerability of High- vs Low-Volume Split-Dose Bowel Cleansing Regimens for Colonoscopy: A Systematic Review and Meta-analysis

Spadaccini

Frazzoni

Vanella

et al. 2020

Clinical Gastroenterology and Hepatology

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BACKGROUND & AIMS: Efficacy of bowel preparation is an important determinant of outcomes of colonoscopy. It is not clear whether approved low-volume polyethylene glycol (PEG) and non-PEG regimens are as effective as high-volume PEG regimens when taken in a split dose. METHODS: In a systematic review of multiple electronic databases through January 31, 2019 with a registered protocol (PROSPERO: CRD42019128067), we identified randomized controlled trials that compared low-vs high-volume bowel cleansing regimens, administered in a split dose, for colonoscopy. The primary efficacy outcome was rate of adequate bowel cleansing, and the secondary efficacy outcome was adenoma detection rate. Primary tolerability outcomes were compliance, tolerability, and willingness to repeat. We calculated relative risk (RR) and 95% CI values and assessed heterogeneity among studies by using the I 2 statistic. The overall quality of evidence was assessed using the GRADE framework.

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Section: Study Characteristics and Qualitymentioning

confidence: 99%

Efficacy and Tolerability of High- vs Low-Volume Split-Dose Bowel Cleansing Regimens for Colonoscopy: A Systematic Review and Meta-analysis

Spadaccini

Frazzoni

Vanella

et al. 2020

Clinical Gastroenterology and Hepatology

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“…In fact, the great majority of gastrointestinal cancers are preventable and curable through early diagnostic and therapeutic gastrointestinal endoscopy, and early screening combined with the resection of precancerous lesions has been confirmed to be an effective method to reduce the incidence and mortality ( 3 – 5 ). Currently, gastrointestinal endoscopy, endoscopic submucosal dissection, and endoscopic mucosal resection have become important methods for the diagnosis and treatment of gastrointestinal cancers because of their comparable safety ( 6 ), superior diagnostic sensitivity ( 7 ), facility of excision of early neoplastic lesions ( 8 ), cost-effectiveness, and minimal invasion ( 9 ) compared with the conventional surgical operation. However, unclear surgical fields caused by peristalsis and miss rates of 5%–32% for polyps remain concerns ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

L-Menthol for Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis

Qin

Chen

et al. 2020

Clin Transl Gastroenterol

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INTRODUCTION: In randomized controlled trials, L-menthol inhibits gastrointestinal peristalsis during endoscopy. Our goal was to quantitatively synthesize the available evidence to evaluate the efficacy and safety of L-menthol for gastrointestinal endoscopy. METHODS: We comprehensively searched for relevant studies published up to January 2020 in PubMed, EMBASE, Web of Science, and Cochrane Library. The main outcomes consisted of the proportion of no peristalsis, proportion of no or mild peristalsis, adenoma detection rate, and adverse events. RESULTS: Eight randomized controlled trials analyzing 1,366 subjects were included. According to the pooled data, L-menthol significantly improved the proportion of no peristalsis (odds ratio [OR] = 6.51, 95% confidence interval [CI] = 4.94–8.57, P < 0.00001), and the proportion of no or mild peristalsis (OR = 7.89, 95% CI = 5.03–12.39, P < 0.00001) compared with the placebo, whereas it was not associated with an improvement in the adenoma detection rate (OR = 1.03, 95% CI = 0.54–1.99, P = 0.92). Adverse events did not differ significantly between the 2 groups (OR = 1.40, 95% CI = 0.75–2.59, P = 0.29). DISCUSSION: The findings of this study support the use of L-menthol to suppress gastrointestinal peristalsis during endoscopic procedure.

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Optimizing Colonoscopy Quality: From Bowel Preparation to Surveillance

Fadel

Shayto

Sharara

2016

Curr Treat Options Gastro

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Colonoscopy is a powerful screening method for colorectal cancer. However, colonoscopy performance is highly variable and quality indicators are needed to ensure delivery of high-quality healthcare. A multi-society task force has recently identified three priority quality indicators in colonoscopy: adenoma detection rate, cecal intubation rate, and adherence to surveillance guidelines. The best-studied quality indicator is the adenoma detection rate, which is inversely correlated to the risk of interval colorectal cancer. Other important quality determinants include colonoscopy withdrawal time and the bowel preparation quality. It is important to note that these quality metrics are interrelated and optimization at every level is necessary for any high-quality colorectal cancer screening and prevention program.

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Split-dose menthol-enhanced PEGvsPEG-ascorbic acid for colonoscopy preparation

Abstract: 4 L PEG plus menthol has better palatability and acceptability than 2 L ascorbic acid- PEG and is associated with a higher rate of excellent preparations; Clinicaltrial.gov identifier: NCT01788709.

Cited by 9 publications

References 33 publications

Efficacy and Tolerability of High- vs Low-Volume Split-Dose Bowel Cleansing Regimens for Colonoscopy: A Systematic Review and Meta-analysis

Efficacy and Tolerability of High- vs Low-Volume Split-Dose Bowel Cleansing Regimens for Colonoscopy: A Systematic Review and Meta-analysis

L-Menthol for Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis

Optimizing Colonoscopy Quality: From Bowel Preparation to Surveillance

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