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Related Experiment Video

Updated: May 29, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Preparation before colonoscopy: a randomized controlled trial comparing different regimes.

Sita V Jansen¹, Jelle G Goedhard, Bjorn Winkens

¹Internal Medicine and Gastroenterology, Atrium Medical Center Parkstad, Heerlen, The Netherlands.

European Journal of Gastroenterology & Hepatology

|September 9, 2011

Summary

A 2-liter polyethylene glycol (PEG) solution with ascorbic acid offers comparable bowel cleansing to a 4-liter PEG solution, with improved patient compliance and taste. Sodium phosphate was less effective for whole colon cleansing.

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Area of Science:

Gastroenterology
Colorectal Surgery
Endoscopy

Background:

Effective bowel preparation is crucial for accurate colonoscopy visualization.
Various bowel cleansing agents exist with differing compositions and volumes.
Patient acceptability and tolerability are key factors in successful bowel preparation.

Purpose of the Study:

To compare the efficacy and patient acceptability of different bowel preparation methods.
To evaluate 2-liter PEG with ascorbic acid against 4-liter PEG.
To assess sodium phosphate and simethicone addition for bowel cleansing.

Main Methods:

Randomized controlled trial involving 461 adult outpatients undergoing colonoscopy.
Comparison of 4-liter PEG, 2-liter PEG with ascorbic acid, and sodium phosphate solutions.
Assessment of bowel cleansing quality by blinded endoscopists and patient-reported outcomes.

Main Results:

2-liter PEG with ascorbic acid demonstrated non-inferior bowel cleansing compared to 4-liter PEG.
Sodium phosphate was non-inferior for rectosigmoid but inferior for whole colon cleansing.
2-liter PEG with ascorbic acid showed better compliance and taste; simethicone offered no benefit.

Conclusions:

2-liter PEG with ascorbic acid is a viable alternative to 4-liter PEG, offering improved patient experience.
Sodium phosphate's efficacy is limited for comprehensive colon cleansing.
Simethicone does not enhance the cleansing quality of PEG solutions.