Efficacy of prokinetics with a split-dose of polyethylene glycol in bowel preparation for morning colonoscopy: a randomized controlled trial.
OBJECTIVE
Currently, a split-dose of polyethylene glycol (PEG) is the mainstay of bowel preparation due to its tolerability, bowel-cleansing action, and safety. However, bowel preparation with PEG is suboptimal because residual fluid reduces the polyp detection rate and requires a more thorough colon inspection. The aim of our study was to demonstrate the efficacy of a sufficient dose of prokinetics on bowel cleansing together with split-dose PEG.


METHODS
A prospective endoscopist-blinded study was conducted. Patients were randomly allocated to two groups: prokinetic with split-dose PEG or split-dose PEG alone. A prokinetic [100 mg itopride (Itomed)], was administered twice simultaneously with each split-dose of PEG. Bowel-cleansing efficacy was measured by endoscopists using the Ottawa scale and the segmental fluidity scale score. Each participant completed a bowel preparation survey. Mean scores from the Ottawa scale, segmental fluid scale, and rate of poor preparation were compared between both groups.


RESULTS
Patients in the prokinetics with split-dose PEG group showed significantly lower total Ottawa and segmental fluid scores compared with patients in the split-dose of PEG alone group.


CONCLUSIONS
A sufficient dose of prokinetics with a split-dose of PEG showed efficacy in bowel cleansing for morning colonoscopy, largely due to the reduction in colonic fluid.
Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea. kto044@paik.ac.kr
Hyoung Jun
HJ
Kim
Tae Oh
TO
Kim
Bong Chul
BC
Shin
Jae Gon
JG
Woo
Eun Hee
EH
Seo
Hee Rin
HR
Joo
Nae-Yun
NY
Heo
Jongha
J
Park
Seung Ha
SH
Park
Sung Yeon
SY
Yang
Young Soo
YS
Moon
Jin-Yong
JY
Shin
Nae Young
NY
Lee
D001549:Benzamides / Q000008:administration & dosage*; D001593:Benzyl Compounds / Q000008:administration & dosage*; D003106:Colon / Q000187:drug effects*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D015203:Reproducibility of Results; D016037:Single-Blind Method; D013501:Surface-Active Agents / Q000008:administration & dosage*
D001549:Benzamides; D001593:Benzyl Compounds; D004338:Drug Combinations; D013501:Surface-Active Agents; D011092:Polyethylene Glycols; C102254:itopride