A head-to-head comparison of 4-L polyethylene glycol and low-volume solutions before colonoscopy: which is the best? A multicentre, randomized trial

• DOI: 10.1007/s00384-017-2901-x
• Publication Date: 2017-09-24T01:08:38Z
• Authors: Vladimir Kojecky; Jan Matous; Radan Keil; Milan Dastych; Radek Kroupa; Zdena Zadorova; Michal Varga; Jiri Dolina; Milan Kment; Ales Hep
• Keywords: Male; Cathartics; Ascorbic Acid; Colonoscopy; Citric Acid; Polyethylene Glycols; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Laxatives; Picolines; 8. Economic growth; Organometallic Compounds; Humans; Female; Citrates; Prospective Studies; Therapeutic Irrigation; Czech Republic

The purpose of this study is to compare the efficacy and tolerability of polyethylene glycol (PEG) to sodium picosulfate/magnesium citrate (SPMC) and low-volume polyethylene glycol/ascorbic acid (PEGA) in a single- or split-dose regimen for colonoscopy bowel preparation.This was a prospective, randomized, endoscopist-blinded, multicentre study. Outpatients received either PEG or SPMC or PEGA in a single or a split dose before the colonoscopy. Quality and tolerability of the preparation and complaints during preparation were recorded.Nine hundred seventy-three patients were analysed. Satisfactory bowel cleansing (Aronchick score 1 + 2) was more frequent when a split dose was used irrespective of the solution type (PEG 90.1 vs 68.8%, PEGA 86.0 vs 71.6%, SPMC 84.3 vs 60.2%, p < 0.001). SPMC was the best tolerated followed by PEGA (p < 0.006) and PEG as the worst (p < 0.001). Tolerability did not correlate with the regimen and amount of the solution used. Female gender is associated with a higher incidence of nausea, vomiting and pain (p < 0.029).Both PEG, PEGA and SPMC are fully comparable in terms of colonic cleansing when used in similar regimens. The split-dose preparation is more effective in all agents. SPMC and PEGA are better tolerated than PEG. The preparation regimen and/or the volume do not affect tolerability.