Efficacy of morning-only 4 liter sulfa free polyethylene glycol vs 2 liter polyethylene glycol with ascorbic acid for afternoon colonoscopy

• Published in: World journal of gastroenterology : WJG 2014-08, Vol.20 (30), p.10620-10627
• Main Authors: Rivas, John M, Perez, Alejandro, Hernandez, Marlow, Schneider, Alison, Castro, Fernando J
• Format: Article
• Language: English
• Subjects: Adenoma - pathology; Ascorbic Acid - administration & dosage; Ascorbic Acid - adverse effects; Bowel; Cathartics - administration & dosage; Cathartics - adverse effects; Colonic Neoplasms - pathology; Colonic Polyps - pathology; colonoscop; Colonoscopy; Drug Administration Schedule; Female; Florida; Humans; Male; Middle Aged; Patient Satisfaction; Polyethylene Glycols - administration & dosage; Polyethylene Glycols - adverse effects; Predictive Value of Tests; preparation; Prospective Studies; Randomized Clinical Trial; Screening; Single-Blind Method; Surveys and Questionnaires; Therapeutic Irrigation - adverse effects; Therapeutic Irrigation - methods; Time Factors
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v20.i30.10620

AIM:To compare the bowel cleansing efficacy of same day ingestion of 4-L sulfa-free polyethylene glycol(4-L SF-PEG)vs 2-L polyethylene glycol solution with ascorbic acid(2-L PEG+Asc)in patients undergoing afternoon colonoscopy.METHODS:206 patients(mean age 56.7 years,61%male)undergoing outpatient screening or surveillance colonoscopies were prospectively randomized to receive either 4-L SF-PEG(n=104)or 2-L PEG+Asc solution(n=102).Colonoscopies were performed by two blinded endoscopists.Bowel preparation was graded using the Ottawa scale.Each participant completed a satisfaction and side effect survey.RESULTS:There was no difference in patient demographics amongst groups.4-L SF-PEG resulted in better Ottawa scores compared to 2-L PEG+Asc,4.2 vs4.9(P=0.0186);left colon:1.33 vs 1.57 respectively(P=0.0224),right colon:1.38 vs 1.63 respectively(P=0.0097).No difference in Ottawa scores was found for the mid colon or amount of fluid.Patient satisfaction was similar for both arms but those assigned to 4-L SF-PEG reported less bloating:23.1%vs 11.5%(P=0.0235).Overall polyp detection,adenomatous polyp and advanced adenoma detection rates were similar between the two groups.CONCLUSION:Morning only 4-L SF-PEG provided superior cleansing with less bloating as compared to 2-L PEG+Asc bowel preparation for afternoon colonoscopy.Thus,future studies evaluating efficacy of morning only preparation for afternoon colonoscopy should use4-L SF-PEG as the standard comparator.