Low-volume PEG plus ascorbic acid versus high-volume PEG as bowel preparation for colonoscopy.

Area of Science:

• Gastroenterology
• Endoscopy

Background:

• High-volume polyethylene glycol (PEG)-based solutions are effective for colonoscopy bowel preparation but often poorly tolerated.
• Optimizing bowel preparation is crucial for successful colonoscopy and patient comfort.

Purpose of the Study:

• To compare the efficacy and tolerability of a 2-liter PEG-based solution with ascorbic acid (PEG + Asc) against a 4-liter PEG-based solution (PEG) for colonoscopy bowel preparation.

Main Methods:

• A single-blind, quasi-randomized, prospective study involving 350 patients undergoing colonoscopy.
• Patients received either 2 L of PEG + Asc or 4 L of PEG, with varying administration schedules (evening before or split dose).
• Bowel preparation efficacy was assessed using a five-point scale across three colon segments, and patient experiences were evaluated via questionnaire.

Main Results:

• Successful colon cleansing was achieved in 90.6% of the PEG + Asc group versus 96% in the PEG group (not statistically significant).
• Bowel cleansing was less effective with PEG + Asc when administered as a full dose the evening before compared to a split dose.
• Patient-reported side-effects and experiences were similar between the PEG + Asc and PEG groups.

Conclusions:

• Low-volume PEG + Asc demonstrates comparable efficacy and tolerability to high-volume PEG for colonoscopy preparation.
• Split-dose administration of PEG + Asc is superior to a full evening-before dose for achieving optimal bowel cleansing.
• The findings support the use of PEG + Asc as a split-dose regimen for colonoscopy preparation.