title: Randomized controlled trial: Standard versus supplemental bowel preparation in patients with Bristol stool form 1 and 2.
abstract: BACKGROUND
  Bristol stool form 1 and 2 is an important predictor of inadequate bowel preparation.
  
  
  OBJECTIVE
  To evaluate the efficacy of supplemental preparation in bowel cleansing quality among patients with Bristol stool form 1 and 2, as well as the feasibility of tailored bowel preparation guided by Bristol stool form scale.
  
  
  METHODS
  Patients with Bristol stool form 1 and 2 from 3 Chinese tertiary hospitals randomly received either 2 L PEG-ELP (group A) or 10 mg bisacodyl plus 2 L PEG-ELP (group B); patients with Bristol stool form 3 to 7 received 2 L PEG-ELP (group C) for bowel preparation. The primary endpoint is the rate of adequate bowel reparation for the whole colon. The adequate bowel preparation rate for separate colon segments, the polyp detection rate (PDR), tolerability, acceptability, sleeping quality and compliance were evaluated as secondary endpoints.
  
  
  RESULTS
  700 patients were randomized. In per-protocol analysis, patients in group B attained significantly higher successful preparation rate than group A (88.7% vs. 61.2%, p<0.001) and similar with group C (88.7% vs. 85.0%, p = 0.316). The PDR in group B was significantly higher than group A (43.2% vs. 25.7%, p<0.001). Acceptability was much higher in group B and C.
  
  
  CONCLUSIONS
  10 mg bisacodyl plus 2 L PEG-ELP can significantly improve both bowel preparation quality and PDR in patients with Bristol stool form 1 and 2. Bristol stool form scale may be an easy and efficient guide for tailored bowel preparation before colonoscopy.
authors.affiliation: Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Yueyue
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Endoscopy, Qianfoshan Hospital of Shandong University, Jinan, China.
authors.forename: Xinyong
authors.initials: X
authors.lastname: Jia
authors.affiliation: Department of Gastroenterology, Binzhou People's Hospital, Binzhou, China.
authors.forename: Baozhen
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Binzhou People's Hospital, Binzhou, China.
authors.forename: Yanmei
authors.initials: Y
authors.lastname: Qi
authors.affiliation: Department of Endoscopy, Qianfoshan Hospital of Shandong University, Jinan, China.
authors.forename: Xiubin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Ji
authors.affiliation: Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Yanbo
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Xiuli
authors.initials: X
authors.lastname: Zuo
authors.affiliation: Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001726:Bisacodyl / Q000008:administration & dosage; D002400:Cathartics / Q000627:therapeutic use*; D002681:China; D003113:Colonoscopy / Q000379:methods*; D005243:Feces; D005260:Female; D006801:Humans; D007422:Intestines / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D011127:Polyps / Q000175:diagnosis; D011446:Prospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002400:Cathartics; D001726:Bisacodyl