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The 1.5-L polyethylene glycol-ascorbic acid (PEG-ASC) bowel preparation is more acceptable than 2-L PEG, with similar efficacy and safety. Proper hydration is crucial for all patients undergoing bowel preparation, regardless of age.

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Area of Science:

  • Gastroenterology
  • Clinical Pharmacology

Background:

  • The hyperosmolarity of polyethylene glycol-ascorbic acid (PEG-ASC) bowel preparation has raised concerns, particularly in elderly populations.
  • Standard 2-L PEG electrolyte solution (PEG-ELS) is widely used but may have tolerability issues.

Purpose of the Study:

  • To compare the efficacy, acceptability, tolerability, and safety of 1.5-L PEG-ASC versus 2-L PEG-ELS.
  • To evaluate these parameters in both the general population and elderly patients (≥70 years).

Main Methods:

  • Randomized study stratified by age (<70 vs. ≥70 years).
  • Comparison of hematological and biochemical parameters to assess safety profiles.
  • Assessment of patient acceptability, tolerability, and bowel cleansing efficacy.

Main Results:

  • 1.5-L PEG-ASC demonstrated higher patient acceptability compared to 2-L PEG-ELS.
  • Tolerability, bowel cleansing, and safety profiles were similar between the two regimens.
  • Significant changes in hematological and biochemical parameters were observed in both groups, highlighting the need for hydration.

Conclusions:

  • 1.5-L PEG-ASC is a well-tolerated and effective alternative to 2-L PEG-ELS, especially for elderly patients.
  • No significant age-related differences in safety were observed.
  • Adequate hydration is essential during bowel preparation with either regimen.