Split-Dose Polyethylene Glycol Is Superior to Single Dose for Colonoscopy Preparation: Results of a Randomized Controlled Trial

Rachid Mohamed, Robert J Hilsden, Catherine Dube, Alaa Rostom, Rachid Mohamed, Robert J Hilsden, Catherine Dube, Alaa Rostom

Abstract

Background. The efficacy of colonoscopy in detecting abnormalities within the colon is highly dependent on the adequacy of the bowel preparation. The objective of this study was to compare the efficacy, safety, and tolerability of PEG lavage and split-dose PEG lavage with specific emphasis on the cleanliness of the right colon. Methods. The study was a prospective, randomized, two-arm, controlled trial of 237 patients. Patients between the age of 50 and 75 years were referred to an outpatient university screening clinic for colonoscopy. Patients were allocated to receive either a single 4 L PEG lavage or a split-dose PEG lavage. Results. Overall, the bowel preparation was superior in the split-dose group compared with the single-dose group (mean Ottawa score 3.50 ± 2.89 versus 5.96 ± 3.53; P < 0.05) and resulted in less overall fluid in the colon. This effect was observed across all segments of the colon assessed. Conclusions. The current study supports use of a split-dose PEG lavage over a single large volume lavage for superior bowel cleanliness, which may improve polyp detection. This trial is registered with ClinicalTrials.gov identifier NCT01610856.

Figures

Figure 1
Figure 1
Ottawa Bowel Prep scores for split-dose and single-dose PEG lavage groups by colon segment and overall. Lower scores are better.
Figure 2
Figure 2
Proportion of patients with adequate bowel preparation (Ottawa Bowel Prep score

Figure 3

Bowel preparation quality for AM…

Figure 3

Bowel preparation quality for AM (earlier than 10:00 AM) and PM (after 10:00…

Figure 3
Bowel preparation quality for AM (earlier than 10:00 AM) and PM (after 10:00 AM) procedures. All single-dose patients took their bowel preparation (4 L PEG) the day before the colonoscopy starting at noon for AM procedures and 6:00 PM for PM procedures. Split-dose patients took the second dose the evening before colonoscopy for AM procedures, or 5 hours before the colonoscopy time for PM procedures.
Figure 3
Figure 3
Bowel preparation quality for AM (earlier than 10:00 AM) and PM (after 10:00 AM) procedures. All single-dose patients took their bowel preparation (4 L PEG) the day before the colonoscopy starting at noon for AM procedures and 6:00 PM for PM procedures. Split-dose patients took the second dose the evening before colonoscopy for AM procedures, or 5 hours before the colonoscopy time for PM procedures.

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Source: PubMed

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