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Bowel preparation with polyethylene glycol electrolyte solution: optimizing the splitting regimen.

Mauro Manno1, Flavia Pigò, Raffaele Manta

  • 1Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile S.Agostino-Estense - Baggiovara di Modena, Modena, Italy. m.manno@ausl.mo.it

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A modified polyethylene glycol (PEG) split regimen significantly improved colonoscopy bowel preparation quality and patient acceptance compared to the standard full regimen. This 3 L plus 1 L PEG approach offers a superior option for effective bowel cleansing.

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Area of Science:

  • Gastroenterology
  • Endoscopic Procedures
  • Colorectal Health

Background:

  • Bowel cleansing quality is crucial for effective colonoscopy.
  • Shorter intervals between bowel solution intake and examination improve cleansing.
  • Polyethylene glycol (PEG) electrolyte solutions are commonly used for bowel preparation.

Purpose of the Study:

  • To evaluate the efficacy and patient tolerability of a modified 3 L plus 1 L PEG splitting regimen for colonoscopy.
  • To compare this modified regimen against a standard 4 L PEG regimen.

Main Methods:

  • A prospective, single-blind, randomized study involving 336 patients.
  • Patients were randomized to receive either 4 L PEG the day before or a split regimen of 3 L the day before and 1 L 3 hours prior to colonoscopy.
  • Bowel preparation quality and patient-reported side-effects were assessed.

Main Results:

  • Both regimens achieved high rates of excellent/good bowel preparation (95.2% vs 92.8%).
  • The modified split regimen showed a significant shift towards 'excellent' preparation (68.4% vs 37.5%).
  • Patient acceptance for repeating the preparation was significantly higher with the split regimen (69% vs 31%).

Conclusions:

  • A modified 3 L plus 1 L PEG split regimen can frequently achieve excellent bowel cleansing.
  • This modified split regimen offers improved patient acceptance compared to standard full PEG regimens.
  • Optimizing PEG split regimens is key to enhancing colonoscopy preparation quality.