Randomized trial of 2-L polyethylene glycol+ascorbic acid versus 4-L polyethylene glycol as bowel cleansing for colonoscopy in an optimal setting

Chang Mo Moon, Dong Il Park, Young Ghil Choe, Dong Hoon Yang, Yeon Hwa Yu, Chang Soo Eun, Dong Soo Han

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Background and Aim: Prior studies have reported 2-L polyethylene glycol (PEG) plus ascorbic acid (PEG+Asc) is an effective alternative to standard 4-L PEG for bowel preparation before colonoscopy, but they are limited because of some confounders. Therefore, we compared the efficacy, patient compliance, satisfaction, and safety of 2-L PEG+Asc versus 4-L PEG for bowel cleansing in optimal preparation strategies. Methods: In this prospective, randomized, single-blind trial, consenting outpatients were randomly assigned to one of two arms. All colonoscopies were scheduled in the morning and cleansing solutions were administered as a split-dose regimen. Bowel-cleansing efficacy in three different segments was measured on a five-point scale with four-point overall grading. Patients' opinions of the preparation regimens were obtained by questionnaire. Results: There was no significant difference between the 2-L PEG+Asc (159/163; 97.5%) and 4-L PEG (162/164; 98.8%) with respect to the overall success of bowel cleansing (mean difference=-1.3 [-4.1-∞]). Patient compliance, acceptability, and satisfaction were better in the 2-L PEG+Asc arm than the 4-L PEG arm (P<0.05). Additionally, the incidence of side effects was lower in the 2-L PEG+Asc than the 4-L PEG (overall, 57.7% vs 73.2%, P<0.05). However, no significant difference was seen in patients' rating of taste. Conclusions: In an optimal preparation setting, 2-L PEG+Asc has equal efficacy as a bowel cleanser prior to colonoscopy as 4-L PEG, with the advantages of better patient compliance, satisfaction, and safety.

Original languageEnglish
Pages (from-to)1223-1228
Number of pages6
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume29
Issue number6
DOIs
StatePublished - Jun 2014

Keywords

  • Ascorbic acid
  • Bowel preparation
  • Colonoscopy
  • Polyethylene glycol

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