Polyethylene glycol-based bowel preparation before colonoscopy for selected inpatients: A pilot study

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Surgery

Background:

• Hospitalized patients often have risk factors for inadequate bowel preparation, impacting colonoscopy efficacy.
• Standard bowel preparation protocols can be challenging for inpatients, potentially leading to suboptimal outcomes.

Purpose of the Study:

• To assess the effectiveness and tolerability of a novel same-day, low-dose 1-L polyethylene glycol (PEG) bowel preparation.
• To evaluate its impact on diagnostic yield in hospitalized patients with risk factors for poor bowel preparation.

Main Methods:

• A prospective pilot study randomized 44 hospitalized patients with poor bowel prep risk factors into two groups.
• Group A received same-day 1-L PEG, while Group B received split-dose 4-L PEG.
• Colonoscopies were performed within 4 hours of the last dose for both groups.

Main Results:

• Optimal bowel cleansing was achieved in 64% (Group A) and 55% (Group B) of patients (P=0.64).
• Adenoma detection rates were 14% (Group A) and 18% (Group B) (P=0.34).
• A valid diagnosis was obtained in 86% of patients, with shorter hospitalizations in the 1-L PEG group (3 vs. 6 days, P=0.04).

Conclusions:

• The same-day, low-dose 1-L PEG regimen facilitates clear diagnoses in high-risk inpatients.
• No significant differences in bowel cleansing success were observed between the 1-L PEG and 4-L PEG groups.
• This 1-L PEG protocol is a viable option for selected hospitalized patients requiring colonoscopy.