A new low-volume isosmotic polyethylene glycol solution plus bisacodyl versus split-dose 4 L polyethylene glycol for bowel cleansing prior to colonoscopy: a randomised controlled trial

Dig Liver Dis. 2013 Jan;45(1):23-7. doi: 10.1016/j.dld.2012.07.011. Epub 2012 Aug 21.

Abstract

Background: 4-L polyethylene glycol preparations are effective for colon cleansing before colonoscopy. However, large volume and unpleasant taste reduce tolerability and acceptability limiting patient compliance. A new isosmotic low-volume polyethylene glycol preparation with citrates and simethicone plus bisacodyl has been developed to improve patient compliance and tolerability.

Aim: To compare the efficacy of 2 different regimens of preparation vs a split-dose of polyethylene glycol solution.

Patients and methods: In this randomised, blinded, comparative study, 153 patients were allocated to 3 arms. Arm 1 (n=52) received bisacodyl and 2-L polyethylene glycol with citrates and simethicone the day before the procedure. Arm 2 (n=50) received bisacodyl the day before and 2-L polyethylene glycol with citrates and simethicone on the day of colonoscopy. Control group (n=51) received a split-dose of 4-L polyethylene glycol. Cleansing was evaluated according to Ottawa scale.

Results: The mean Ottawa score was not different in the 3 groups. Excellent cleansing was observed more frequently in arm 2 (70%) than in controls (49%) (p<0.05). No serious adverse events were observed in the 3 regimens. The willingness to repeat the same bowel preparation was superior in arms 1 and 2 than in controls (p<0.001).

Conclusions: New low-volume preparations seem to be as effective as the split 4-L polyethylene glycol regimen, showing a better tolerability and acceptability.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bisacodyl / adverse effects
  • Bisacodyl / therapeutic use*
  • Cathartics / adverse effects
  • Cathartics / therapeutic use*
  • Citric Acid
  • Colonoscopy / methods*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance
  • Polyethylene Glycols / adverse effects
  • Polyethylene Glycols / therapeutic use*
  • Simethicone
  • Single-Blind Method
  • Surface-Active Agents / adverse effects
  • Surface-Active Agents / therapeutic use*
  • Treatment Outcome
  • Young Adult

Substances

  • Cathartics
  • Surface-Active Agents
  • Bisacodyl
  • Citric Acid
  • Polyethylene Glycols
  • Simethicone