Polyethylene glycol versus split high-dose senna for bowel preparation: A comparative prospective randomized study.

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Endoscopy

Background:

• Effective bowel preparation is crucial for successful colonoscopies.
• Traditional bowel cleansing agents like polyethylene glycol (PEG) can have tolerability issues.

Purpose of the Study:

• To compare the efficacy and tolerability of split high-dose senna versus split-dose PEG for bowel preparation.
• To evaluate colon cleansing quality, patient compliance, and adverse events.

Main Methods:

• A prospective, randomized, endoscopist-blinded study involving 474 outpatients.
• Patients were assigned to receive either split high-dose senna (1000 mg) or 4 L of PEG.
• Bowel preparation quality was assessed using the Boston Bowel Preparation Scale (BBPS).

Main Results:

• The senna group demonstrated significantly better bowel preparation quality (mean BBPS 7.35 vs. 6.57) and higher adequate cleansing rates (89.9% vs. 73.8%).
• Senna group experienced less vomiting (12.7% vs. 29.5%) and nausea (28.7% vs. 43.9%), but more abdominal pain (70.9% vs. 43%).
• Higher cecal intubation rates (95.4% vs. 86.1%) were observed in the senna group.

Conclusions:

• Split high-dose senna is more effective than split-dose PEG for bowel preparation, improving quality and compliance.
• Senna offers a favorable side-effect profile regarding nausea and vomiting, though abdominal pain is more frequent.
• Senna presents a promising alternative to PEG for optimizing bowel preparation in endoscopic procedures.