A new low-volume isosmotic polyethylene glycol solution plus bisacodyl versus split-dose 4 L polyethylene glycol for bowel cleansing prior to colonoscopy: a randomised controlled trial.
BACKGROUND
4-L polyethylene glycol preparations are effective for colon cleansing before colonoscopy. However, large volume and unpleasant taste reduce tolerability and acceptability limiting patient compliance. A new isosmotic low-volume polyethylene glycol preparation with citrates and simethicone plus bisacodyl has been developed to improve patient compliance and tolerability.


OBJECTIVE
To compare the efficacy of 2 different regimens of preparation vs a split-dose of polyethylene glycol solution.


METHODS
In this randomised, blinded, comparative study, 153 patients were allocated to 3 arms. Arm 1 (n=52) received bisacodyl and 2-L polyethylene glycol with citrates and simethicone the day before the procedure. Arm 2 (n=50) received bisacodyl the day before and 2-L polyethylene glycol with citrates and simethicone on the day of colonoscopy. Control group (n=51) received a split-dose of 4-L polyethylene glycol. Cleansing was evaluated according to Ottawa scale.


RESULTS
The mean Ottawa score was not different in the 3 groups. Excellent cleansing was observed more frequently in arm 2 (70%) than in controls (49%) (p<0.05). No serious adverse events were observed in the 3 regimens. The willingness to repeat the same bowel preparation was superior in arms 1 and 2 than in controls (p<0.001).


CONCLUSIONS
New low-volume preparations seem to be as effective as the split 4-L polyethylene glycol regimen, showing a better tolerability and acceptability.
Digestive Endoscopy Unit, Catholic University, Rome, Italy. pacesaro@gmail.com
Paola
P
Cesaro
Cesare
C
Hassan
Cristiano
C
Spada
Lucio
L
Petruzziello
Giovanna
G
Vitale
Guido
G
Costamagna
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001726:Bisacodyl / Q000009:adverse effects / Q000627:therapeutic use*; D002400:Cathartics / Q000009:adverse effects / Q000627:therapeutic use*; D019343:Citric Acid; D003113:Colonoscopy / Q000379:methods*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D012841:Simethicone; D016037:Single-Blind Method; D013501:Surface-Active Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D002400:Cathartics; D013501:Surface-Active Agents; D001726:Bisacodyl; D019343:Citric Acid; D011092:Polyethylene Glycols; D012841:Simethicone