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Evaluation of the efficacy of 1 L polyethylene glycol plus ascorbic acid and an oral sodium sulfate solution: A
Jung Hun Woo1, Hoon Sup Koo1, Dae Sung Kim1
1Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea.
Insights
Low-volume bowel preparation using 1 L polyethylene glycol/ascorbic acid (PEG/Asc) is comparable to oral sodium sulfate (OSS) in efficacy and patient compliance. Both agents demonstrated similar safety profiles in this clinical trial.
Area of Science:
- Gastroenterology
- Clinical Trials
- Colorectal Health
Background:
- Low-volume bowel preparation regimens aim to improve patient adherence.
- Comparing polyethylene glycol/ascorbic acid (PEG/Asc) with oral sodium sulfate (OSS) is crucial for optimizing colonoscopy preparation.
Purpose of the Study:
- To compare the efficacy, compliance, and safety of 1 L PEG/Asc versus oral sodium sulfate (OSS) for bowel preparation.
- To evaluate patient experience and adverse events associated with these low-volume bowel cleansing agents.
Main Methods:
- A multicenter, prospective, randomized, single-blinded, non-inferiority trial involving 172 patients.
- Bowel preparation efficacy assessed using the Boston Bowel Preparation Scale (BBPS).
- Patient-reported outcomes (satisfaction, taste, adverse events) and laboratory safety markers (serum creatinine) were analyzed.
Main Results:
- Comparable Boston Bowel Preparation Scale scores between 1 L PEG/Asc and OSS, with a trend towards higher scores in the right colon for PEG/Asc.
- Similar patient compliance rates for both bowel preparation agents.
- Increased thirst and dizziness reported with PEG/Asc; gastrointestinal symptoms like vomiting and abdominal distension were more frequent with OSS. Both agents showed potential for serum creatinine elevation, mostly within normal ranges.
Conclusions:
- One liter of PEG/Asc demonstrates non-inferiority to OSS for bowel preparation efficacy and compliance.
- Both bowel preparation methods are comparable in safety, with distinct side effect profiles.
- These findings support the use of 1 L PEG/Asc as an effective alternative for colon cleansing.
Introduction:
Low-volume bowel preparation has been developed to increase patient compliance. We compared 1 L of polyethylene glycol/ascorbic acid (PEG/Asc) and oral sodium sulfate (OSS) with respect to bowel preparation efficacy, compliance, and safety.
Methods:
A multicenter, prospective, randomized, single-blinded, non-inferiority trial was conducted in 3 hospitals. Patients were randomized to receive a bowel-cleansing agent. Bowel-cleansing efficacy was evaluated using the Boston Bowel Preparation Scale (BBPS). Satisfaction, feeling, taste of the bowel cleanser, and adverse events after taking the bowel cleanser were investigated through a questionnaire. Additionally, blood samples were analyzed before and after bowel cleansing.
Results:
In total, 172 patients were analyzed (85 with 1 L PEG/Asc and 87 with OSS), and the mean BBPS scores were comparable between agents. The 1L PEG/Asc group tended to have a higher BBPS score in the right colon (2.22 vs 2.02; P = .08). The compliance of 1 L of PEG/Asc was comparable to that of OSS. Patients taking 1 L PEG/Asc reported greater thirst and dizziness (P = .04 and P = .047, respectively) than the OSS cohort. On the other hand, gastrointestinal symptoms such as vomiting and abdominal distension were more common in the OSS group, without statistical significance. In terms of laboratory adverse events, elevation of serum creatinine was found in both groups after taking the bowel cleansing agent (P < .001 for the 1L PEG/Asc group; P = .04 for the OSS group). However, most of the increased values were within the normal ranges.
Discussion:
The 1L PEG/Asc treatment was comparable to OSS in terms of bowel preparation efficacy, compliance, and safety.
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