Split-dose vs same-day reduced-volume polyethylene glycol electrolyte lavage solution for morning colonoscopy

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Effective bowel preparation is crucial for successful colonoscopy.
• Traditional whole-dose regimens can be associated with poor tolerability.

Purpose of the Study:

• To compare the efficacy and tolerability of split-dose versus whole-dose 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for morning colonoscopy.

Main Methods:

• A randomized controlled trial involving 295 adult patients undergoing morning colonoscopy.
• Patients received either a split-dose or whole-dose of 2-litre PEG-ELS plus bisacodyl.
• Bowel preparation quality was assessed using the Boston Bowel Preparation Scale (BBPS), and patient tolerability was evaluated via questionnaires.

Main Results:

• Split-dose PEG-ELS demonstrated comparable bowel preparation quality to the whole-dose regimen (BBPS scores: 6 [6-8] vs 6 [6-7], P = 0.038).
• No significant differences were observed in colonoscopy procedural times or adenoma detection rates.
• Patients in the split-dose group reported significantly less nausea, vomiting, and a higher likelihood of completing the preparation and preferring the same regimen for future procedures.

Conclusions:

• Split-dose 2-litre PEG-ELS is a safe and effective alternative to whole-dose regimens for morning colonoscopy.
• The split-dose approach offers superior patient tolerability and preference, potentially improving adherence to bowel preparation protocols.