A randomized controlled trial evaluating a new 2-L PEG solution plus ascorbic acid vs 4-L PEG for bowel cleansing...

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Surgery

Background:

• Effective bowel preparation is crucial for colonoscopy safety and efficacy.
• High fluid volumes in traditional bowel preparations can reduce patient tolerance.
• A novel 2-L polyethylene glycol (PEG) solution with ascorbic acid has been developed to address these issues.

Purpose of the Study:

• To compare the efficacy, safety, and acceptability of a 2-L PEG solution with ascorbic acid against a 4-L PEG solution for colonoscopy.
• To evaluate bowel cleansing quality and patient experience with different PEG formulations.

Main Methods:

• A single-blind, randomized, non-inferiority study design was employed.
• Bowel cleansing was assessed by endoscopists using the Aronchick scale.
• Patient acceptability was evaluated through questionnaires, with intention-to-treat (ITT) and per-protocol (PP) analyses conducted.

Main Results:

• The 2-L PEG with ascorbic acid group showed a higher rate of excellent-good bowel cleansing (84.6% ITT, 86.2% PP) compared to the 4-L PEG group (75.3% ITT, 77% PP).
• Patient acceptability was significantly better for the 2-L PEG with ascorbic acid (83%) versus the 4-L PEG (76%).

Conclusions:

• The 2-L PEG with ascorbic acid, supplemented with clear fluids, demonstrates superior bowel cleansing efficacy compared to the 4-L PEG preparation.
• This newer formulation offers improved patient acceptability, potentially enhancing compliance and overall colonoscopy experience.