title: Split-dose menthol-enhanced PEG vs PEG-ascorbic acid for colonoscopy preparation.
abstract: OBJECTIVE
  To compare the efficacy and palatability of 4 L polyethylene glycol electrolyte (PEG) plus sugar-free menthol candy (PEG + M) vs reduced-volume 2 L ascorbic acid-supplemented PEG (AscPEG).
  
  
  METHODS
  In a randomized controlled trial setting, ambulatory patients scheduled for elective colonoscopy were prospectively enrolled. Patients were randomized to receive either PEG + M or AscPEG, both split-dosed with minimal dietary restriction. Palatability was assessed on a linear scale of 1 to 5 (1 = disgusting; 5 = tasty). Quality of preparation was scored by assignment-blinded endoscopists using the modified Aronchick and Ottawa scales. The main outcomes were the palatability and efficacy of the preparation. Secondary outcomes included patient willingness to retake the same preparation again in the future and completion of the prescribed preparation.
  
  
  RESULTS
  Overall, 200 patients were enrolled (100 patients per arm). PEG + M was more palatable than AscPEG (76% vs 62%, P = 0.03). Completing the preparation was not different between study groups (91% PEG + M vs 86% AscPEG, P = 0.38) but more patients were willing to retake PEG + M (54% vs 40% respectively, P = 0.047). There was no significant difference between PEG + M vs AscPEG in adequate cleansing on both the modified Aronchick (82% vs 77%, P = 0.31) and the Ottawa scale (85% vs 74%, P = 0.054). However, PEG + M was superior in the left colon on the Ottawa subsegmental score (score 0-2: 94% for PEG + M vs 81% for AscPEG, P = 0.005) and received significantly more excellent ratings than AscPEG on the modified Aronchick scale (61% vs 43%, P = 0.009). Both preparations performed less well in afternoon vs morning examinations (inadequate: 29% vs 15.2%, P = 0.02).
  
  
  CONCLUSIONS
  4 L PEG plus menthol has better palatability and acceptability than 2 L ascorbic acid- PEG and is associated with a higher rate of excellent preparations; Clinicaltrial.gov identifier: NCT01788709.
authors: Ala I Sharara, Ali H Harb, Fayez S Sarkis, Jean M Chalhoub, Rami Badreddine, Fadi H Mourad, Mahmoud Othman, Omar Masri, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, 11-0236/16-B Beirut, Lebanon.
authors: Ala I
authors: AI
authors: Sharara
authors: Ala I Sharara, Ali H Harb, Fayez S Sarkis, Jean M Chalhoub, Rami Badreddine, Fadi H Mourad, Mahmoud Othman, Omar Masri, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, 11-0236/16-B Beirut, Lebanon.
authors: Ali H
authors: AH
authors: Harb
authors: Ala I Sharara, Ali H Harb, Fayez S Sarkis, Jean M Chalhoub, Rami Badreddine, Fadi H Mourad, Mahmoud Othman, Omar Masri, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, 11-0236/16-B Beirut, Lebanon.
authors: Fayez S
authors: FS
authors: Sarkis
authors: Ala I Sharara, Ali H Harb, Fayez S Sarkis, Jean M Chalhoub, Rami Badreddine, Fadi H Mourad, Mahmoud Othman, Omar Masri, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, 11-0236/16-B Beirut, Lebanon.
authors: Jean M
authors: JM
authors: Chalhoub
authors: Ala I Sharara, Ali H Harb, Fayez S Sarkis, Jean M Chalhoub, Rami Badreddine, Fadi H Mourad, Mahmoud Othman, Omar Masri, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, 11-0236/16-B Beirut, Lebanon.
authors: Rami
authors: R
authors: Badreddine
authors: Ala I Sharara, Ali H Harb, Fayez S Sarkis, Jean M Chalhoub, Rami Badreddine, Fadi H Mourad, Mahmoud Othman, Omar Masri, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, 11-0236/16-B Beirut, Lebanon.
authors: Fadi H
authors: FH
authors: Mourad
authors: Ala I Sharara, Ali H Harb, Fayez S Sarkis, Jean M Chalhoub, Rami Badreddine, Fadi H Mourad, Mahmoud Othman, Omar Masri, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, 11-0236/16-B Beirut, Lebanon.
authors: Mahmoud
authors: M
authors: Othman
authors: Ala I Sharara, Ali H Harb, Fayez S Sarkis, Jean M Chalhoub, Rami Badreddine, Fadi H Mourad, Mahmoud Othman, Omar Masri, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, 11-0236/16-B Beirut, Lebanon.
authors: Omar
authors: O
authors: Masri
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives; D002182:Candy; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy; D005260:Female; D005421:Flavoring Agents / Q000008:administration & dosage*; D006801:Humans; D007861:Lebanon; D008297:Male; D008610:Menthol / Q000008:administration & dosage*; D008875:Middle Aged; D017060:Patient Satisfaction; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D013649:Taste / Q000187:drug effects; D007507:Therapeutic Irrigation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D002400:Cathartics; D005421:Flavoring Agents; D008610:Menthol; D011092:Polyethylene Glycols; D001205:Ascorbic Acid
keywords: Bowel preparation; Colonoscopy; Efficacy; Menthol; Tolerability