title: A low-volume polyethylene glycol plus ascorbate solution for bowel cleansing prior to colonoscopy: the NORMO randomised clinical trial.
abstract: BACKGROUND
  Patient acceptability of the preparation is a key factor in the success of colonoscopy, yet standard polyethylene glycol solutions are poorly tolerated owing to their high volume (4L) and low palatability. This study compared the efficacy, safety and acceptability of a 2L polyethylene glycol+ascorbate solution with a standard 4-L polyethylene glycol solution.
  
  
  METHODS
  Adults referred for colonoscopy were randomised to 2-L polyethylene glycol+ascorbate (n=202) or 4-L polyethylene glycol solution (n=198). Colon cleansing success was assessed using the Harefield Cleansing Scale(©) and the Aronchick scale. Safety and acceptability were also assessed.
  
  
  RESULTS
  Successful cleansing was achieved in 94.1% and 90.9% of subjects with the 2-L and 4-L solutions respectively using the Harefield Cleansing Scale(©) and 94.6% and 90.0% using the Aronchick scale (non significant). Despite better acceptability and tolerability, no superiority over the standard 4-L preparation was demonstrated. Fewer treatment-related adverse events were reported with the 2-L solution (80.2% versus 89.9%, p=0.011). More subjects were willing to take the 2L PEG+ascorbate solution again (87% versus 51%, p<0.001), found it easier to drink (80% versus 70%, p=0.025), with a better taste (p=0.01).
  
  
  CONCLUSIONS
  Two-litre polyethylene glycol+ascorbate solution, with a similar high degree of cleansing and superior acceptability and tolerability, presents an alternative to 4-L polyethylene glycol when compliance is an issue.
authors.affiliation: Service d'Hépato-Gastro-Entérologie, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Ponchon
authors.forename: Christian
authors.initials: C
authors.lastname: Boustière
authors.forename: Denis
authors.initials: D
authors.lastname: Heresbach
authors.forename: Hervé
authors.initials: H
authors.lastname: Hagege
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Tarrerias
authors.forename: Marc
authors.initials: M
authors.lastname: Halphen
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D057240:Patient Preference; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011300:Preoperative Care / Q000009:adverse effects; D016037:Single-Blind Method
chemical_list: D011092:Polyethylene Glycols; D001205:Ascorbic Acid
keywords: Ascorbic acid; Bowel cleansing; Colonoscopy; Low volume PEG solution; PEG+Asc; Polyethylene glycol solution