BACKGROUND: Bowel preparation is critical for the efficacy and safety of colonoscopy. Poor patient tolerance to bowel preparation has been associated with the high amount of fluid administered. A 2-L polyethylene glycol (PEG) solution containing ascorbic acid has been recently developed. AIMS: To compare the efficacy, safety and acceptability of 2-L PEG+ascorbic acid vs 4-L PEG for colonoscopy. METHODS: We designed a single blind randomized non-inferiority study in order to compare the two bowel preparations. A blinded assessment of cleansing was made by the endoscopist according to the Aronchick scale. Acceptability was assessed by questionnaire. Intention-to-treat (ITT) and per-protocol (PP) analysis were reported. RESULTS: Overall, 169 patients (PP: 166) were selected for the 2-L PEG+ascorbic acid and 170 (PP: 166) for the 4-L PEG. When rating global bowel cleansing at ITT, an excellent-good level was reported in 84.6% (PP: 86.2%) of patients who received 2-L PEG+ascorbic acid and 75.3% (PP: 77%) of patients who received 4-L PEG (p=0.04). Acceptability rate favoured 2-L PEG+ascorbic acid vs 4-L PEG (83% vs 76%; p=0.02). CONCLUSIONS:2-L PEG+ascorbic acid, completed with an additional L of clear fluids, provided bowel cleansing which appeared to be more effective and acceptable than 4-L PEG.
RCT Entities:
BACKGROUND: Bowel preparation is critical for the efficacy and safety of colonoscopy. Poor patient tolerance to bowel preparation has been associated with the high amount of fluid administered. A 2-L polyethylene glycol (PEG) solution containing ascorbic acid has been recently developed. AIMS: To compare the efficacy, safety and acceptability of 2-LPEG+ascorbic acid vs 4-LPEG for colonoscopy. METHODS: We designed a single blind randomized non-inferiority study in order to compare the two bowel preparations. A blinded assessment of cleansing was made by the endoscopist according to the Aronchick scale. Acceptability was assessed by questionnaire. Intention-to-treat (ITT) and per-protocol (PP) analysis were reported. RESULTS: Overall, 169 patients (PP: 166) were selected for the 2-LPEG+ascorbic acid and 170 (PP: 166) for the 4-LPEG. When rating global bowel cleansing at ITT, an excellent-good level was reported in 84.6% (PP: 86.2%) of patients who received 2-LPEG+ascorbic acid and 75.3% (PP: 77%) of patients who received 4-LPEG (p=0.04). Acceptability rate favoured 2-LPEG+ascorbic acid vs 4-LPEG (83% vs 76%; p=0.02). CONCLUSIONS: 2-LPEG+ascorbic acid, completed with an additional L of clear fluids, provided bowel cleansing which appeared to be more effective and acceptable than 4-LPEG.
Authors: Vladimir M Kushnir; Pavan Bhat; Reena V Chokshi; Alexander Lee; Brian B Borg; Chandra Prakash Gyawali; Gregory S Sayuk Journal: Dig Liver Dis Date: 2013-09-06 Impact factor: 4.088
Authors: Kyong Joo Lee; Hong Jun Park; Hyun-Soo Kim; Kwang Ho Baik; Yeon Soo Kim; Sung Chul Park; Hyun Il Seo Journal: World J Gastroenterol Date: 2015-03-14 Impact factor: 5.742
Authors: Yoon Suk Jung; Chang Kyun Lee; Hyo Jong Kim; Chang Soo Eun; Dong Soo Han; Dong Il Park Journal: World J Gastroenterol Date: 2014-11-14 Impact factor: 5.742
Authors: Sung-Won Jung; Da Hye Jung; Young Chul Shin; In Ho Moh; Hana Yoo; Sung Il Jang; Su Rin Shin; Jin Bae Kim; Sang Hoon Park; Myung Seok Lee Journal: Dig Dis Sci Date: 2014-09-06 Impact factor: 3.199