Patient-directed vs. fixed-volume PEG for colonoscopy preparation: a randomized controlled trial

Area of Science:

• Gastroenterology
• Clinical Medicine
• Patient Care

Background:

• Individualized bowel preparation with varying polyethylene glycol (PEG) volumes is considered optimal.
• A patient-directed regimen offers a potentially reliable alternative for personalized bowel cleansing.

Purpose of the Study:

• To evaluate the efficacy, safety, and patient satisfaction of a novel patient-directed bowel preparation regimen.
• To compare the patient-directed approach with a standard fixed-volume PEG regimen.

Main Methods:

• Patients were assigned to either a fixed-volume or a patient-directed PEG group.
• The patient-directed group adjusted PEG intake based on stool consistency or water content.
• Efficacy, adverse effects, comfort, and willingness for future colonoscopy were assessed.

Main Results:

• No significant difference in bowel preparation efficacy was observed between the groups (90.0% vs. 90.3%).
• The patient-directed group reported fewer adverse effects (36.9% vs. 53.0%) and less vomiting (1.0% vs. 13.6%).
• Patient satisfaction and willingness for future colonoscopy were higher in the patient-directed group.

Conclusions:

• The patient-directed regimen improves safety and satisfaction without reducing bowel preparation efficacy.
• This regimen is a viable individualized solution for bowel preparation.
• Lower body mass index is associated with better adherence to the patient-directed regimen.