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2 L PEG plus ascorbic acid versus 4 L PEG plus simethicon for colonoscopy preparation: a randomized single-blind
Maurizio Gentile1, Michele De Rosa, Giovanni Cestaro
1Department of General, Oncological, and Videoassisted Surgery, University of Naples Federico II, Naples, Italy. magentil@unina.it
Summary
Low-volume polyethylene glycol (PEG) with ascorbic acid offers comparable efficacy and tolerability to high-volume PEG with simethicon for bowel preparation. This suggests a viable alternative for patients requiring colon cleansing.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Clinical Trials
Background:
- Reduced-volume polyethylene glycol (PEG) solutions (2 L) demonstrate comparable safety and efficacy to higher-volume (4 L) formulations.
- Ascorbic acid and simethicon are additives used in PEG-based bowel preparation solutions.
Purpose of the Study:
- To compare the efficacy and patient tolerability of a low-volume PEG solution with ascorbic acid against a high-volume PEG solution with simethicon.
- Evaluate colon cleansing effectiveness and patient-reported outcomes.
Main Methods:
- A single-blind, prospective, randomized trial was conducted.
- Patients received either 2 L PEG plus ascorbic acid (PEG+Asc) or 4 L PEG plus simethicon (PEG+Sim).
- Colon cleansing was assessed using the Aronchick score; secondary endpoints included compliance, tolerability, and adverse events.
Main Results:
- Overall adequate bowel cleansing was achieved in 81.67% of the PEG+Asc group and 80% of the PEG+Sim group.
- Excellent or good cleansing ratings were observed in 11.6% and 38.3% for PEG+Asc, versus 26.6% and 23.3% for PEG+Sim, respectively.
- Patient tolerability and safety profiles were similar between the two preparations.
Conclusions:
- Low-volume PEG with ascorbic acid (PEG+Asc) is a comparable alternative to high-volume PEG with simethicon (PEG+Sim) for bowel preparation regarding efficacy, safety, and tolerability.
- Further research is needed to optimize bowel preparation for achieving perfect colon cleansing.
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