Randomised clinical trial: low-volume bowel preparation for colonoscopy - a comparison between two different...

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Low-volume bowel preparations with polyethylene glycol (PEG) offer improved tolerability.
• A novel iso-osmotic, sulphate-free formulation, PEG-Citrate-Simethicone (PEG-CS) with bisacodyl, has been developed for colonoscopy.

Purpose of the Study:

• To compare the bowel cleansing quality of PEG-CS with bisacodyl versus PEG-Ascorbate (PEG-ASC).
• To evaluate tolerability, acceptability, and compliance of the two bowel preparations in adult out-patients.

Main Methods:

• A randomized, observer-blind, parallel group study was conducted in five Italian centers.
• Participants received either PEG-CS with bisacodyl or PEG-ASC, with bowel cleansing assessed using the Boston Bowel Preparation Scale.
• Mucosal visibility, tolerability, acceptability, and compliance were also evaluated.

Main Results:

• The study included 408 adult out-patients (mean age 59.1-59.4 years).
• Successful bowel preparation rates were 79.1% for PEG-CS with bisacodyl versus 70% for PEG-ASC (P < 0.05).
• Optimal mucosal visibility was achieved in 56.1% with PEG-CS/bisacodyl compared to 46.3% with PEG-ASC (P < 0.05). No serious adverse events were reported.

Conclusions:

• Polyethylene glycol-Citrate-Simethicone with bisacodyl demonstrated superior efficacy in bowel cleansing for outpatient colonoscopy compared to PEG-Ascorbate.
• Both low-volume bowel preparations exhibited similar tolerability, safety, acceptability, and compliance profiles.