title: Low-volume plus ascorbic acid vs high-volume plus simethicone bowel preparation before colonoscopy.
abstract: OBJECTIVE
  To investigate the effectiveness of low-volume plus ascorbic acid [polyethylene glycol plus ascorbic acid (PEG + Asc)] and high-volume plus simethicone [polyethylene glycol plus simethicone (PEG + Sim)] bowel preparations.
  
  
  METHODS
  A total of one hundred and forty-four outpatients (76 males), aged from 20 to 84 years (median age 59.5 years), who attended our Department, were divided into two groups, age and sex matched, and underwent colonoscopy. Two questionnaires, one for patients reporting acceptability and the other for endoscopists evaluating bowel cleansing effectiveness according to validated scales, were completed. Indications, timing of examination and endoscopical findings were recorded. Biopsy forceps were used as a measuring tool in order to determine polyp endoscopic size estimation. Difficulty in completing the preparation was rated in a 5-point Likert scale (1 = easy to 5 = unable). Adverse experiences (fullness, cramps, nausea, vomiting, abdominal pain, headache and insomnia), number of evacuations and types of activities performed during preparation (walking or resting in bed) were also investigated.
  
  
  RESULTS
  Seventy-two patients were selected for each group. The two groups were age and sex matched as well as being comparable in terms of medical history and drug therapies taken. Fourteen patients dropped out from the trial because they did not complete the preparation procedure. Ratings of global bowel cleansing examinations were considered to be adequate in 91% of PEG + Asc and 88% of PEG + Sim patients. Residual Stool Score indicated similar levels of amount and consistency of residual stool; there was a significant difference in the percentage of bowel wall visualization in favour of PEG + Sim patients. In the PEG + Sim group, 12 adenomas ≤ 10 mm diameter (5/left colon + 7/right colon) vs 9 (8/left colon + 1/right colon) in the PEG + Asc group were diagnosed. Visualization of small lesions seems to be one of the primary advantages of the PEG + Sim preparation.
  
  
  CONCLUSIONS
  PEG + Asc is a good alternative solution as a bowel preparation but more improvements are necessary in order to achieve the target of a perfect preparation.
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, 00161 Roma, Italy. stefano.pontone@uniroma1.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Pontone
authors.forename: Rita
authors.initials: R
authors.lastname: Angelini
authors.forename: Monica
authors.initials: M
authors.lastname: Standoli
authors.forename: Gregorio
authors.initials: G
authors.lastname: Patrizi
authors.forename: Franco
authors.initials: F
authors.lastname: Culasso
authors.forename: Paolo
authors.initials: P
authors.lastname: Pontone
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000627:therapeutic use; D001205:Ascorbic Acid / Q000627:therapeutic use*; D002400:Cathartics / Q000627:therapeutic use*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis; D004643:Emollients / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019999:Pharmaceutical Solutions / Q000737:chemistry / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012841:Simethicone / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000379:methods*; D055815:Young Adult
chemical_list: D000975:Antioxidants; D002400:Cathartics; D004643:Emollients; D019999:Pharmaceutical Solutions; D011092:Polyethylene Glycols; D012841:Simethicone; D001205:Ascorbic Acid