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Updated: Jun 5, 2025
06:28
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
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Comparative efficacy of different bowel preparations for colonoscopy: A network meta-analysis
Summary
The best bowel preparations for colonoscopy are 2 L PEG with simethicone or lactulose, and 1 L PEG with ascorbate, offering high cleansing success. Only 2 L PEG with simethicone also improved adenoma detection rates.
Area of Science:
- Gastroenterology
- Endoscopy
- Pharmacology
Background:
- Colonoscopy quality depends on effective bowel cleansing.
- Comparative efficacy of various bowel preparation solutions is uncertain.
Purpose of the Study:
- To compare the performance of different bowel preparations for colonoscopy using a systematic review and network meta-analysis.
Main Methods:
- Systematic search of MEDLINE, Embase, Scopus, and Cochrane Library for RCTs.
- Primary outcome: cleansing success (CS). Secondary outcome: adenoma detection rate (ADR).
Main Results:
- 2 L PEG + simethicone, 2 L PEG + lactulose, and 1 L PEG + ascorbate showed superior CS compared to 2 L PEG + ascorbate.
- 2 L PEG + lactulose (SUCRA 0.94) and 2 L PEG + simethicone (SUCRA 0.93) were the most effective for CS.
- Only 2 L PEG + simethicone significantly improved ADR (RR = 1.60).
Conclusions:
- 2 L PEG + simethicone, 2 L PEG + lactulose, and 1 L PEG + ascorbate are recommended for high CS.
- 2 L PEG + simethicone is preferred for its significant improvement in ADR.
- Further studies are needed to compare ADR for these preparations.
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