Efficacy of prokinetics with a split-dose of polyethylene glycol in bowel preparation for morning colonoscopy: a randomized controlled trial

Digestion. 2012;86(3):194-200. doi: 10.1159/000339780. Epub 2012 Aug 17.

Abstract

Background/aims: Currently, a split-dose of polyethylene glycol (PEG) is the mainstay of bowel preparation due to its tolerability, bowel-cleansing action, and safety. However, bowel preparation with PEG is suboptimal because residual fluid reduces the polyp detection rate and requires a more thorough colon inspection. The aim of our study was to demonstrate the efficacy of a sufficient dose of prokinetics on bowel cleansing together with split-dose PEG.

Methods: A prospective endoscopist-blinded study was conducted. Patients were randomly allocated to two groups: prokinetic with split-dose PEG or split-dose PEG alone. A prokinetic [100 mg itopride (Itomed)], was administered twice simultaneously with each split-dose of PEG. Bowel-cleansing efficacy was measured by endoscopists using the Ottawa scale and the segmental fluidity scale score. Each participant completed a bowel preparation survey. Mean scores from the Ottawa scale, segmental fluid scale, and rate of poor preparation were compared between both groups.

Results: Patients in the prokinetics with split-dose PEG group showed significantly lower total Ottawa and segmental fluid scores compared with patients in the split-dose of PEG alone group.

Conclusion: A sufficient dose of prokinetics with a split-dose of PEG showed efficacy in bowel cleansing for morning colonoscopy, largely due to the reduction in colonic fluid.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Benzamides / administration & dosage*
  • Benzyl Compounds / administration & dosage*
  • Colon / drug effects*
  • Colonoscopy / methods*
  • Colorectal Neoplasms / diagnosis
  • Dose-Response Relationship, Drug
  • Drug Combinations
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance
  • Polyethylene Glycols / administration & dosage*
  • Prospective Studies
  • Reproducibility of Results
  • Single-Blind Method
  • Surface-Active Agents / administration & dosage*

Substances

  • Benzamides
  • Benzyl Compounds
  • Drug Combinations
  • Surface-Active Agents
  • Polyethylene Glycols
  • itopride