title: A randomized controlled trial evaluating a new 2-L PEG solution plus ascorbic acid vs 4-L PEG for bowel cleansing prior to colonoscopy.
abstract: BACKGROUND
  Bowel preparation is critical for the efficacy and safety of colonoscopy. Poor patient tolerance to bowel preparation has been associated with the high amount of fluid administered. A 2-L polyethylene glycol (PEG) solution containing ascorbic acid has been recently developed.
  
  
  OBJECTIVE
  To compare the efficacy, safety and acceptability of 2-L PEG+ascorbic acid vs 4-L PEG for colonoscopy.
  
  
  METHODS
  We designed a single blind randomized non-inferiority study in order to compare the two bowel preparations. A blinded assessment of cleansing was made by the endoscopist according to the Aronchick scale. Acceptability was assessed by questionnaire. Intention-to-treat (ITT) and per-protocol (PP) analysis were reported.
  
  
  RESULTS
  Overall, 169 patients (PP: 166) were selected for the 2-L PEG+ascorbic acid and 170 (PP: 166) for the 4-L PEG. When rating global bowel cleansing at ITT, an excellent-good level was reported in 84.6% (PP: 86.2%) of patients who received 2-L PEG+ascorbic acid and 75.3% (PP: 77%) of patients who received 4-L PEG (p=0.04). Acceptability rate favoured 2-L PEG+ascorbic acid vs 4-L PEG (83% vs 76%; p=0.02).
  
  
  CONCLUSIONS
  2-L PEG+ascorbic acid, completed with an additional L of clear fluids, provided bowel cleansing which appeared to be more effective and acceptable than 4-L PEG.
authors: Department of Gastroenterology, "Santa Maria del Prato" Hospital, Feltre, Bolzano, Italy.
authors: Flavio
authors: F
authors: Valiante
authors: Stefano
authors: S
authors: Pontone
authors: Cesare
authors: C
authors: Hassan
authors: Angelo
authors: A
authors: Bellumat
authors: Manuela
authors: M
authors: De Bona
authors: Angelo
authors: A
authors: Zullo
authors: Vincenzo
authors: V
authors: de Francesco
authors: Michele
authors: M
authors: De Boni
mesh_terms: D000368:Aged; D001205:Ascorbic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D016037:Single-Blind Method; D014815:Vitamins / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D002400:Cathartics; D014815:Vitamins; D011092:Polyethylene Glycols; D001205:Ascorbic Acid