title: Miralax with gatorade for bowel preparation: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Polyethylene glycol (PEG) is a very popular bowel preparation for colonoscopy. However, its large volume may reduce patient compliance, resulting in suboptimal preparation. Recently, a combination of Miralax and Gatorade has been studied in various randomized controlled trials (RCTs) as a lower volume and more palatable bowel preparation. However, results have varied. Therefore, we conducted a meta-analysis assessing the use of Miralax-Gatorade (M-G) vs. PEG for bowel preparation before colonoscopy.
  
  
  METHODS
  Multiple databases were searched (January 2014). RCTs on adults comparing M-G (238-255 g in 1.9 l that is 64 fl oz) vs. PEG (3.8-4 l) for bowel preparation before colonoscopy were included. The effects were analyzed by calculating pooled estimates of quality of bowel preparation (satisfactory, unsatisfactory, excellent), patient tolerance (nausea, cramping, bloating), and polyp detection by using odds ratio (OR) with fixed- and random-effects models.
  
  
  RESULTS
  Five studies met inclusion criteria (N=1,418), with mean age ranging from 53.8 to 61.3 years. M-G demonstrated statistically significantly fewer satisfactory bowel preparations as compared with PEG (OR 0.65; 95% confidence interval (CI): 0.43-0.98, P=0.04) but more willingness to repeat preparation (OR 7.32; 95% CI: 4.88-10.98, P<0.01). Furthermore, no statistically significant differences in polyp detection (P=0.65) or side effects were apparent between the two preparations for nausea (P=0.71), cramping (P=0.84), or bloating (P=0.50). Subgroup analysis revealed similar results for split-dose M-G vs. split-dose PEG.
  
  
  CONCLUSIONS
  M-G for bowel preparation before colonoscopy was inferior to PEG in bowel preparation quality while demonstrating no significant improvements in adverse effects or polyp detection. Therefore, PEG appears superior to M-G for bowel preparation before colonoscopy.
authors.affiliation: Division of Gastroenterology, University of Missouri-Columbia, Columbia, Missouri, USA.
authors.forename: Sameer
authors.initials: S
authors.lastname: Siddique
authors.affiliation: Division of Gastroenterology, University of Missouri-Columbia, Columbia, Missouri, USA.
authors.forename: Kristi T
authors.initials: KT
authors.lastname: Lopez
authors.affiliation: Division of Gastroenterology, University of Missouri-Columbia, Columbia, Missouri, USA.
authors.forename: Alisha M
authors.initials: AM
authors.lastname: Hinds
authors.affiliation: Division of Gastroenterology, University of Missouri-Columbia, Columbia, Missouri, USA.
authors.forename: Dina S
authors.initials: DS
authors.lastname: Ahmad
authors.affiliation: Division of Gastroenterology, University of California- Irvine, Irvine, California, USA.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Nguyen
authors.affiliation: Division of Gastroenterology, University of Missouri-Columbia, Columbia, Missouri, USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Matteson-Kome
authors.affiliation: Division of Gastroenterology, University of Illinois-Peoria, Peoria, Arizona, USA.
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Puli
authors.affiliation: Division of Gastroenterology, University of Missouri-Columbia, Columbia, Missouri, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Bechtold
mesh_terms: D000328:Adult; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic
chemical_list: D002400:Cathartics; D007552:Isotonic Solutions; C011259:gatorade; D011092:Polyethylene Glycols