Colonoscopy preparation: polyethylene glycol with Gatorade is as safe and efficacious as four liters of polyethylene glycol with balanced electrolytes.
BACKGROUND
Four liters of polyethylene glycol 3350 (PEG) with balanced electrolytes for colonoscopy preparation has had poor acceptance. Another approach is the use of electrolyte-free PEG combined with 1.9 L of Gatorade. Despite its widespread use, there are no data on metabolic safety and minimal data on efficacy. Our aim was to assess the efficacy and electrolyte safety of these two PEG-based preparations.


METHODS
This was a prospective, randomized, single-blind, non-inferiority trial. Patients were randomized to 238 g PEG + 1.9 L Gatorade or 4 L of PEG-ELS containing 236 g PEG. Split dosing was not performed. On procedure day blood was drawn for basic chemistries. The primary outcome was preparation quality from procedure photos using the Boston Bowel Preparation Scale.


RESULTS
We randomized 136 patients (66 PEG + Gatorade, 70 PEG-ELS). There were no differences in preparation scores between the two agents in the ITT analysis (7.2 ± 1.9 for PEG-ELS and 7.0 ± 2.1 for PEG + Gatorade; p = 0.45). BBPS scores were identical for those who completed the preparation and dietary instructions as directed (7.4 ± 1.7 for PEG-ELS, and 7.4 ± 1.8 for PEG + Gatorade; p = 0.98). There were no statistical differences in serum electrolytes between the two preparations. Patients who received PEG + Gatorade gave higher overall satisfaction scores for the preparation experience (p = 0.001), and had fewer adverse effects.


CONCLUSIONS
Use of 238 g PEG + 1.9 L Gatorade appears to be safe, better tolerated, and non-inferior to 4 L PEG-ELS. This preparation may be especially useful for patients who previously tolerated PEG-ELS poorly.
Gastroenterology Section, Temple University School of Medicine, 3401 North Broad Street, Philadelphia, PA 19140, USA. Thomas.mckenna@tuhs.temple.edu
Thomas
T
McKenna
Alice
A
Macgill
Gail
G
Porat
Frank K
FK
Friedenberg
D002400:Cathartics / Q000494:pharmacology*; D003113:Colonoscopy; D004359:Drug Therapy, Combination; D004573:Electrolytes / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000494:pharmacology*; D016037:Single-Blind Method; D016896:Treatment Outcome
D002400:Cathartics; D004573:Electrolytes; D007552:Isotonic Solutions; C011259:gatorade; D011092:Polyethylene Glycols