Literature DB >> 20606677

Morning-only one-gallon polyethylene glycol improves bowel cleansing for afternoon colonoscopies: a randomized endoscopist-blinded prospective study.

Shibu Varughese1, Anand R Kumar, Amy George, Fernando J Castro.   

Abstract

OBJECTIVES: Inadequate bowel preparation is a known factor associated with increased failure rates of afternoon colonoscopy and lower adenoma detection rates. The aim of our study was to compare the efficacy of bowel cleansing achieved by administering 1-gallon (4 l) polyethylene glycol (PEG) preparation to patients in the morning of an afternoon colonoscopy with that of the traditional evening regimen.
METHODS: A prospective endoscopist-blinded study was conducted, in which patients undergoing afternoon colonoscopy were randomized to receive either 1 gallon of PEG the evening before the procedure or the morning of the colonoscopy. Bowel cleansing efficacy was scored by a blinded endoscopist using the Ottawa scale and each participant filled out a satisfaction survey. Mean scores for each bowel segment, composite mean scores, and rates of "good prep" interpreted from the Ottawa scale were compared between the two groups.
RESULTS: A total of 136 patients (mean age 51.8 years, 52.2% men) evenly distributed between the two groups formed the study sample. Patients in the morning group had significantly lower Ottawa scale scores and were more likely to have a good preparation for each bowel segment and overall when compared with the evening group (P<0.01). Moreover, patients in the morning group were over 50% less likely to lose sleep or have bloating compared with the evening group (P<0.05). There was no difference in the study groups on overall polyp detection rate, adenomatous polyps, or number of patients with adenomas.
CONCLUSIONS: This study shows that the bowel cleansing efficacy of morning-only 1-gallon PEG is superior and better tolerated compared with consumption of 1-gallon PEG in the evening before the day of an afternoon colonoscopy. Thus, administering 1-gallon PEG solution in the morning of an afternoon colonoscopy is a feasible option that can improve the quality of an afternoon colonoscopy.

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Year:  2010        PMID: 20606677     DOI: 10.1038/ajg.2010.271

Source DB:  PubMed          Journal:  Am J Gastroenterol        ISSN: 0002-9270            Impact factor:   10.864


  22 in total

1.  Removal of infused water predominantly during insertion (water exchange) is consistently associated with an increase in adenoma detection rate - review of data in randomized controlled trials (RCTs) of water-related methods.

Authors:  Fw Leung; Jo Harker; Jw Leung; Rm Siao-Salera; Sk Mann; Fc Ramirez; S Friedland; A Amato; F Radaelli; S Paggi; V Terruzzi; Yh Hsieh
Journal:  J Interv Gastroenterol       Date:  2011-07-01

2.  Improving the quality of bowel preparation: one step closer to the holy grail?

Authors:  Edward W Holt; Michael S Verhille
Journal:  Dig Dis Sci       Date:  2011-02       Impact factor: 3.199

3.  Benchmarking and quality-screening colonoscopy.

Authors:  Felix W Leung
Journal:  J Interv Gastroenterol       Date:  2012-07-01

4.  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.

Authors:  Miguel Muñoz-Navas; José Luis Calleja; Guillermo Payeras; Antonio José Hervás; Luis Esteban Abreu; Víctor Orive; Pedro L Menchén; José María Bordas; José Ramón Armengol; Cristina Carretero; Vicente Pons Beltrán; Inmaculada Alonso-Abreu; Román Manteca; Adolfo Parra-Blanco; Fernando Carballo; Juan Manuel Herrerías; Carlos Badiola
Journal:  Int J Colorectal Dis       Date:  2015-07-16       Impact factor: 2.571

5.  Quality indicators for colonoscopy.

Authors:  Douglas K Rex; Philip S Schoenfeld; Jonathan Cohen; Irving M Pike; Douglas G Adler; M Brian Fennerty; John G Lieb; Walter G Park; Maged K Rizk; Mandeep S Sawhney; Nicholas J Shaheen; Sachin Wani; David S Weinberg
Journal:  Am J Gastroenterol       Date:  2014-12-02       Impact factor: 10.864

Review 6.  Bowel cleansing before colonoscopy: Balancing efficacy, safety, cost and patient tolerance.

Authors:  Nicole M Harrison; Michael C Hjelkrem
Journal:  World J Gastrointest Endosc       Date:  2016-01-10

7.  Retrospective analysis showing the water method increased adenoma detection rate - a hypothesis generating observation.

Authors:  Joseph W Leung; Lynne D Do; Rodelei M Siao-Salera; Catherine Ngo; Dhavan A Parikh; Surinder K Mann; Felix W Leung
Journal:  J Interv Gastroenterol       Date:  2011-01

8.  The water method significantly enhances proximal diminutive adenoma detection rate in unsedated patients.

Authors:  Felix W Leung; Joseph W Leung; Rodelei M Siao-Salera; Surinder K Mann
Journal:  J Interv Gastroenterol       Date:  2011-01

9.  Same-day 2-L PEG-citrate-simethicone plus bisacodyl vs split 4-L PEG: Bowel cleansing for late-morning colonoscopy.

Authors:  Annalisa de Leone; Darina Tamayo; Giancarla Fiori; Davide Ravizza; Cristina Trovato; Giuseppe De Roberto; Linda Fazzini; Marco Dal Fante; Cristiano Crosta
Journal:  World J Gastrointest Endosc       Date:  2013-09-16

10.  Quality indicators for colorectal cancer screening for colonoscopy.

Authors:  Philip S Schoenfeld; Jonathan Cohen
Journal:  Tech Gastrointest Endosc       Date:  2013-04
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