Efficacy and Tolerability of Split-dose PEG Compared with Split-dose Aqueous Sodium Phosphate for Outpatient Colonoscopy: a Randomized, Controlled Trial

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2011 Jun 10

PMID 21656179

Citations 7

Authors

Eun Hee Seo

Tae Oh Kim

Tae Gyoon Kim

Hee Rin Joo

Min Jae Park

Jongha Park

Seung Ha Park

Sung Yeon Yang

Young Soo Moon

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Adequate bowel cleansing is essential for a high-quality, effective, and safe colonoscopy. The aims of this study were to compare the efficacy and tolerability of split-dose polyethylene glycol with aqueous sodium phosphate for outpatients who underwent scheduled colonoscopy.

Methods: In this prospective trial, 207 outpatients (aged between 18 and 65 years, with normal renal function, at low risk for renal damage) were randomized to receive split-dose preparation of PEG (2 L/2 L) (N = 103) or NaP (45 mL/45 mL, 12 h apart) (N = 104) without strict diet restriction the day before colonoscopy. The bowel cleansing efficacy of preparations was rated according to the Ottawa scale and the patient tolerability was assessed using a patient questionnaire.

Results: There was no significant difference between the two groups for the mean total score using the Ottawa bowel preparation scale (P = 0.181). Significantly greater residual colonic fluid was observed in the split-dose PEG group (1.24 ± 0.49) than in the NaP group (1.04 ± 0.53) (P = 0.007). Patient compliance, preference, and acceptance of a two preparation regimen were similar with no significant differences (P = 0.095, P = 0.280 and P = 0.408, respectively). The overall incidence of adverse events was not significantly different between the two groups; however, the split-dose PEG group tended to have fewer adverse events (52/103 [50.5%], 66/104 [63.5%], P = 0.059) and had significantly less nausea and vomiting (P = 0.036).

Conclusions: Split-dose PEG, compared with split-dose NaP, is associated with more residual colonic fluid, but produces equivalent colon cleansing efficacy and results in less nausea and vomiting, which might improve patient tolerability (clinical trial registration number NCT01229800).

Citing Articles

Predictive Model of Functional Exercise Compliance of Patients with Breast Cancer Based on Decision Tree.

Luo Z, Luo B, Wang P, Wu J, Chen C, Guo Z Int J Womens Health. 2023; 15:397-410.

PMID: 36974132 PMC: 10039631. DOI: 10.2147/IJWH.S386405.

Electrolyte disturbances after bowel preparation for colonoscopy: Systematic review and meta-analysis.

Reumkens A, van der Zander Q, Winkens B, Bogie R, Bakker C, Sanduleanu S Dig Endosc. 2022; 34(5):913-926.

PMID: 35037327 PMC: 9543544. DOI: 10.1111/den.14237.

Effect of an intensive patient educational programme on the quality of bowel preparation for colonoscopy: a single-blind randomised controlled trial.

Janahiraman S, Tay C, Lee J, Lim W, Khiew C, Ishak I BMJ Open Gastroenterol. 2020; 7(1).

PMID: 32371502 PMC: 7228661. DOI: 10.1136/bmjgast-2020-000376.

Sodium phosphate versus polyethylene glycol for colonoscopy bowel preparation: an updated meta-analysis of randomized controlled trials.

Cheng J, Tao K, Shuai X, Gao J Surg Endosc. 2015; 30(9):4033-41.

PMID: 26679172 DOI: 10.1007/s00464-015-4716-6.

Comparison of the Efficacy and Tolerability between Same-day Picosulfate and Split-dose Polyethylene Glycol Bowel Preparation for Afternoon Colonoscopy: A Prospective, Randomized, Investigator-blinded Trial.

Kang M, Kim T, Seo E, Jung D, Kim M, Heo N Intest Res. 2014; 12(1):53-9.

PMID: 25349564 PMC: 4204690. DOI: 10.5217/ir.2014.12.1.53.

References

Abdul-Baki H, Hashash J, Elhajj I, Azar C, El Zahabi L, Mourad F . A randomized, controlled, double-blind trial of the adjunct use of tegaserod in whole-dose or split-dose polyethylene glycol electrolyte solution for colonoscopy preparation. Gastrointest Endosc. 2008; 68(2):294-300. DOI: 10.1016/j.gie.2008.01.044. View

Vanner S, MacDonald P, Paterson W, Prentice R, Da Costa L, Beck I . A randomized prospective trial comparing oral sodium phosphate with standard polyethylene glycol-based lavage solution (Golytely) in the preparation of patients for colonoscopy. Am J Gastroenterol. 1990; 85(4):422-7. View

Hookey L, Depew W, Vanner S . The safety profile of oral sodium phosphate for colonic cleansing before colonoscopy in adults. Gastrointest Endosc. 2002; 56(6):895-902. DOI: 10.1067/mge.2002.129522. View

Markowitz G, Nasr S, Klein P, Anderson H, Stack J, Alterman L . Renal failure due to acute nephrocalcinosis following oral sodium phosphate bowel cleansing. Hum Pathol. 2004; 35(6):675-84. DOI: 10.1016/j.humpath.2003.12.005. View

Ell C, Fischbach W, Keller R, Dehe M, Mayer G, Schneider B . A randomized, blinded, prospective trial to compare the safety and efficacy of three bowel-cleansing solutions for colonoscopy (HSG-01*). Endoscopy. 2003; 35(4):300-4. DOI: 10.1055/s-2003-38150. View

Parra-Blanco A, Nicolas-Perez D, Gimeno-Garcia A, Grosso B, Jimenez A, Ortega J . The timing of bowel preparation before colonoscopy determines the quality of cleansing, and is a significant factor contributing to the detection of flat lesions: a randomized study. World J Gastroenterol. 2006; 12(38):6161-6. PMC: 4088110. DOI: 10.3748/wjg.v12.i38.6161. View

Wexner S, Beck D, Baron T, Fanelli R, Hyman N, Shen B . A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American.... Gastrointest Endosc. 2006; 63(7):894-909. DOI: 10.1016/j.gie.2006.03.918. View

Cohen L, Kastenberg D, Mount D, Safdi A . Current Issues in Optimal Bowel Preparation: Excerpts From a Roundtable Discussion Among Colon-Cleansing Experts. Gastroenterol Hepatol (N Y). 2023; 5(11 Suppl 19):3-11. PMC: 2886377. View

Eun C, Han D, Hyun Y, Bae J, Park H, Kim T . The timing of bowel preparation is more important than the timing of colonoscopy in determining the quality of bowel cleansing. Dig Dis Sci. 2010; 56(2):539-44. DOI: 10.1007/s10620-010-1457-1. View

10.

Tan J, Tjandra J . Which is the optimal bowel preparation for colonoscopy - a meta-analysis. Colorectal Dis. 2006; 8(4):247-58. DOI: 10.1111/j.1463-1318.2006.00970.x. View

11.

Unger R, Amstutz S, Seo D, Huffman M, Rex D . Willingness to undergo split-dose bowel preparation for colonoscopy and compliance with split-dose instructions. Dig Dis Sci. 2010; 55(7):2030-4. DOI: 10.1007/s10620-009-1092-x. View

12.

Cohen S, Wexner S, Binderow S, Nogueras J, Daniel N, Ehrenpreis E . Prospective, randomized, endoscopic-blinded trial comparing precolonoscopy bowel cleansing methods. Dis Colon Rectum. 1994; 37(7):689-96. DOI: 10.1007/BF02054413. View

13.

Adams W, Meagher A, Lubowski D, King D . Bisacodyl reduces the volume of polyethylene glycol solution required for bowel preparation. Dis Colon Rectum. 1994; 37(3):229-33; discussion 233-4. DOI: 10.1007/BF02048160. View

14.

. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: a report by the American Society of Anesthesiologist Task.... Anesthesiology. 1999; 90(3):896-905. DOI: 10.1097/00000542-199903000-00034. View

15.

Marmo R, Rotondano G, Riccio G, Marone A, Bianco M, Stroppa I . Effective bowel cleansing before colonoscopy: a randomized study of split-dosage versus non-split dosage regimens of high-volume versus low-volume polyethylene glycol solutions. Gastrointest Endosc. 2010; 72(2):313-20. DOI: 10.1016/j.gie.2010.02.048. View

16.

Young C, Simpson R, King D, Lubowski D . Oral sodium phosphate solution is a superior colonoscopy preparation to polyethylene glycol with bisacodyl. Dis Colon Rectum. 2000; 43(11):1568-71. DOI: 10.1007/BF02236740. View

17.

Harewood G, Sharma V, de Garmo P . Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest Endosc. 2003; 58(1):76-9. DOI: 10.1067/mge.2003.294. View

18.

Aasebo W, Scott H, Ganss R . Kidney biopsies taken before and after oral sodium phosphate bowel cleansing. Nephrol Dial Transplant. 2006; 22(3):920-2. DOI: 10.1093/ndt/gfl694. View

19.

Henderson J, Barnett J, Turgeon D, Elta G, Behler E, Crause I . Single-day, divided-dose oral sodium phosphate laxative versus intestinal lavage as preparation for colonoscopy: efficacy and patient tolerance. Gastrointest Endosc. 1995; 42(3):238-43. DOI: 10.1016/s0016-5107(95)70098-6. View

20.

Aoun E, Abdul-Baki H, Azar C, Mourad F, Barada K, Berro Z . A randomized single-blind trial of split-dose PEG-electrolyte solution without dietary restriction compared with whole dose PEG-electrolyte solution with dietary restriction for colonoscopy preparation. Gastrointest Endosc. 2005; 62(2):213-8. DOI: 10.1016/s0016-5107(05)00371-8. View