Related Experiment Video
Updated: Jun 12, 2026
Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis
Published on: January 5, 2017
Efficacy and acceptability of bowel preparation strategies for inflammatory bowel disease colonoscopy: Systematic
Gaurav B Nigam1, Morris Gordon2, Vassiliki Sinopoulou2
1Translational Gastroenterology and Liver Unit, Nuffield Department of Medicine, Experimental Medicine Division, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom of Great Britain and Northern Ireland.
Background And Study Aims:
Patients with inflammatory bowel disease (IBD) frequently undergo colonoscopy, each requiring bowel preparation. European Society of Gastrointestinal Endoscopy (ESGE) 2019 guidelines recommended high- or low-volume polyethylene glycol (PEG)-based bowel prep for IBD patients; however other non-PEG-based preparations (sulphate and picosulphate-based) have now been studied in IBD.
Methods:
We searched CENTRAL, ClinicalTrials.gov, Embase, MEDLINE, and the World Health Organization International Clinical Trials Registry Platform for randomized controlled trials (RCTs) up to December 2024. Primary outcome was bowel prep success; secondary outcomes included tolerability, acceptability, cecal intubation rates (CIR) and safety. Pooled estimates used risk ratio (RR) and GRADE to assess evidence certainty.
Results:
Ten RCTs (1479 IBD patients) were included. There was no difference in prep success (relative risk [RR] 0.98, 95% confidence interval [CI] 0.88-1.09; I 2 = 33%, 2 RCTs; moderate certainty evidence) between 2 L vs. 4 L PEG, but higher acceptability for 2 L (RR 0.69, 95% CI 0.59-0.80; I 2 = 18%, 2 RCTs; high certainty evidence). Low-volume non-PEG vs. PEG are probably similar for prep success (RR 0.96, 95% CI 0.90-1.01; I 2 = 6%,3 RCTs; moderate certainty evidence). The evidence on tolerability and acceptability was very uncertain. Subgroup analysis revealed comparable effectiveness of picosulphate-based (RR 0.89, 95% CI 0.78-1.01; I 2 = 0%,1 RCT) and sulphate-based preps (RR 0.98, 95% CI 0.91-1.05; I 2 = 28%, 2 RCTs) compared with low-volume PEG. Safety data were inconsistently reported.
Conclusions:
High-certainty evidence supports low-volume PEG as comparably successful to high-volume PEG, with higher acceptability. Moderate-certainty evidence indicates similar success between non-PEG and PEG-based preps. Both low-volume PEG and non-PEG-based preps are supported for use in IBD, broadening options beyond current ESGE guidelines.
More Related Videos
06:28E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
03:43Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
Related Concept Videos
01:29Drugs for Treatment of Ulcerative Colitis in IBD
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
01:25Endoscopic Procedures II: Colonoscopy