title: Split-dose bowel preparation for colonoscopy and residual gastric fluid volume: an observational study.
abstract: BACKGROUND
  Split-dose bowel preparations for colonoscopy are more effective and better tolerated than preparations given entirely the day or evening before the procedure; however, some resistance to split-dose preparation stems from concerns about an increased risk of aspiration with same-day preparation.
  
  
  OBJECTIVE
  We sought to evaluate residual gastric volumes in patients after split-dose bowel preparations.
  
  
  METHODS
  Prospective measurement of residual gastric volumes in patients undergoing same-day EGD and colonoscopy after split-dose bowel preparations, patients undergoing EGD alone, or patients undergoing EGD and colonoscopy after bowel preparation given entirely the evening before the procedure.
  
  
  METHODS
  Tertiary care hospital-based endoscopy unit.
  
  
  METHODS
  This study involved 712 patients, including 254 in the split-dose bowel preparation group, 411 in the EGD-only group, and 47 in the evening-before-procedure bowel preparation group.
  
  
  METHODS
  Measurement of residual gastric volume before endoscopic procedures.
  
  
  METHODS
  Residual gastric volume.
  
  
  RESULTS
  The mean residual gastric volume in patients receiving split-dose bowel preparation (19.7 mL) was higher than in patients undergoing EGD alone (14.6 mL) but not different from that in patients receiving bowel preparation the evening before the procedure (20.2 mL). Within the split-dose preparation group, there was no association between the interval from last actual fluid ingestion and procedure start time and the residual gastric volume. The range of residual gastric volumes between study arms was similar.
  
  
  CONCLUSIONS
  Nonrandomized study. The number of inpatients undergoing split-dose bowel preparation was small.
  
  
  CONCLUSIONS
  These data support the safety of split-dose bowel preparation for outpatients undergoing colonoscopy.
authors.affiliation: Division of Gastroenterology/Hepatology, Indiana University Hospital, Indianapolis, Indiana, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Huffman
authors.forename: R Zackary
authors.initials: RZ
authors.lastname: Unger
authors.forename: Chandana
authors.initials: C
authors.lastname: Thatikonda
authors.forename: Sable
authors.initials: S
authors.lastname: Amstutz
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Rex
mesh_terms: D000328:Adult; D000368:Aged; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy / Q000379:methods*; D004334:Drug Administration Schedule; D004384:Duodenoscopy; D005260:Female; D005766:Gastrointestinal Contents; D005773:Gastroscopy; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D053120:Respiratory Aspiration
chemical_list: D002400:Cathartics