Comparison of two different methods of colon cleansing for afternoon-colonoscopy

The appropriate colon cleansing is a major determinant of quality of colonoscopy. This prospective randomized study was designed to compare the efficacy and tolerability of the morning (AM) PEG (polyethylene glycol) solution to previous-evening (PM) PEG solution for the afternoon colonoscopy.

This comparative study compared the AM to PM prep for afternoon outpatient colonoscopy. The subjects randomly received PEG PM dose ;4 liters of water plus 4 pack PEG powder at 6 pm before colonoscopy (250 ml every 15 min) or AM ( the same dose solution at 6 am on the day of colonoscopy). The preparation and colonoscopy quality, PEG side effects, sleep quality, lesion detection, flush need and suction fluid were compared in these two groups.

One hundred seven cases received AM prep and 102 received PM prep. The colon prep was adequate in 94.4% in AM group and in 90.2% cases in PM group (P=0.2). The incidence of adverse events in these two groups was similar. Sleep quality and the need for flush was lower in the AM group (P=0.004 and P=0.03). The mean volume of suction fluid was higher in the AM group (P=0.01). The detected lesions were similar between the two groups. Adequate prep was associated with lower flush need in AM group (P=0.001).

AM and PM PEG solutions were clinically equivalent with cleansing efficacy and side effect and lesion detection. AM group was associated with a better sleep quality and less flush need, but more suction fluid.