title: Bowel preparation with split-dose polyethylene glycol before colonoscopy: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Polyethylene glycol (PEG) is a commonly used bowel preparation for colonoscopy. Unfortunately, the standard large-volume solution may reduce patient compliance. Split-dosing of PEG has been studied in various randomized, controlled trials (RCTs). However, results have been conflicting.
  
  
  OBJECTIVE
  We conducted a meta-analysis to assess the role of split-dose PEG versus full-dose PEG for bowel preparation before colonoscopy.
  
  
  METHODS
  Multiple databases were searched (January 2011). RCTs on adults comparing full-dose and split-dose of PEG for bowel preparation before colonoscopy were included and analyzed by calculating pooled estimates of quality of bowel preparation, preparation compliance, willingness to repeat the same preparation, and side effects by using odds ratio (OR) by fixed and random-effects models.
  
  
  METHODS
  Literature search.
  
  
  METHODS
  Per RCTs.
  
  
  METHODS
  Satisfactory bowel preparation, willingness to repeat same bowel preparation, patient compliance, and side effects.
  
  
  RESULTS
  Five trials met inclusion criteria (N = 1232). Split-dose PEG significantly increased the number of satisfactory bowel preparations (OR 3.70; 95% CI, 2.79-4.91; P < .01) and willingness to repeat the same preparation (OR 1.76; 95% CI, 1.06-2.91; P = .03) compared with full-dose PEG. Split-dose PEG also significantly decreased the number of preparation discontinuations (OR 0.53; 95% CI, 0.28-0.98; P = .04) and nausea (OR 0.55; 95% CI, 0.38-0.79; P < .01) compared with full-dose PEG.
  
  
  CONCLUSIONS
  Limited number of studies.
  
  
  CONCLUSIONS
  The use of a split-dose PEG for bowel preparation before colonoscopy significantly improved the number of satisfactory bowel preparations, increased patient compliance, and decreased nausea compared with the full-dose PEG.
authors.affiliation: Division of Gastroenterology, University of Missouri School of Medicine, Columbia, Missouri, USA.
authors.forename: Todd W
authors.initials: TW
authors.lastname: Kilgore
authors.forename: Abdillahi A
authors.initials: AA
authors.lastname: Abdinoor
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Szary
authors.forename: Samuel W
authors.initials: SW
authors.lastname: Schowengerdt
authors.forename: Jamie B
authors.initials: JB
authors.lastname: Yust
authors.forename: Abhishek
authors.initials: A
authors.lastname: Choudhary
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Matteson
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Puli
authors.forename: John B
authors.initials: JB
authors.lastname: Marshall
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Bechtold
mesh_terms: D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy / Q000379:methods*; D006801:Humans; D009325:Nausea / Q000139:chemically induced; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D013501:Surface-Active Agents / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D002400:Cathartics; D013501:Surface-Active Agents; D011092:Polyethylene Glycols