title: Preparation before colonoscopy: a randomized controlled trial comparing different regimes.
abstract: OBJECTIVE
  A good bowel preparation is essential for optimal visualization of the large intestine. Several preparations with a difference in composition and volume are available. We compared five methods for bowel cleansing quality and patients' acceptability.
  
  
  METHODS
  Adult ambulatory outpatients scheduled for elective colonoscopy were randomized to receive 4-l polyethylene glycol (PEG) solution (Klean-prep), 2-l PEG solution+ascorbic acid (Moviprep), or a sodium phosphate (NaP) solution, Phosphoral. Patients with the PEG solutions were also randomized to receive simethicone (Aeropax), to investigate whether this improves the bowel cleansing efficacy. Before colonoscopy patients completed a questionnaire about the acceptability and tolerability of the preparation. Endoscopists blinded to the type of preparation gave a bowel cleansing score.
  
  
  RESULTS
  Data were available for 461 patients. 2-l PEG+ascorbic acid was noninferior to 4-l PEG in bowel cleansing quality of rectosigmoid and colon. NaP was noninferior to 4-l PEG in bowel cleansing quality of rectosigmoid but inferior for the whole colon. Compliance was significantly less in the group with 4-l PEG compared with the 2-l PEG and NaP group. No difference was found for abdominal cramps. Taste was significantly better in the 2-l PEG group. Simethicone did not improve the bowel cleansing quality.
  
  
  CONCLUSIONS
  2-l PEG+ascorbic acid was noninferior to the 4-l PEG solution in bowel cleansing quality and was better in taste and compliance. NaP was inferior to 4-l PEG in bowel cleansing quality. Addition of simethicone gave no improvement.
authors: Internal Medicine and Gastroenterology, Atrium Medical Center Parkstad, Heerlen, The Netherlands.
authors: Sita V
authors: SV
authors: Jansen
authors: Jelle G
authors: JG
authors: Goedhard
authors: Bjorn
authors: B
authors: Winkens
authors: Cees Th B M
authors: CT
authors: van Deursen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000934:Antifoaming Agents; D002400:Cathartics / Q000627:therapeutic use*; D003113:Colonoscopy / Q000379:methods*; D004643:Emollients; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010710:Phosphates / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012841:Simethicone; D016037:Single-Blind Method; D007507:Therapeutic Irrigation / Q000379:methods; D055815:Young Adult
chemical_list: D000934:Antifoaming Agents; D002400:Cathartics; D004643:Emollients; C520497:MoviPrep; D010710:Phosphates; D011092:Polyethylene Glycols; D012841:Simethicone; C018279:sodium phosphate