Does Polyethylene Glycol (PEG) Plus Ascorbic Acid Induce More Mucosal Injuries than Split-Dose 4-L PEG during Bowel Preparation?

Gut Liver. 2016 Mar;10(2):237-43. doi: 10.5009/gnl14439.

Abstract

Background/aims: The aims of this study were to compare the bowel-cleansing efficacy, patient affinity for the preparation solution, and mucosal injury between a split dose of polyethylene glycol (SD-PEG) and low-volume PEG plus ascorbic acid (LV-PEG+Asc) in outpatient scheduled colonoscopies.

Methods: Of the 319 patients, 160 were enrolled for SDPEG, and 159 for LV-PEG+Asc. The bowel-cleansing efficacy was rated according to the Ottawa bowel preparation scale. Patient affinity for the preparation solution was assessed using a questionnaire. All mucosal injuries observed during colonoscopy were biopsied and histopathologically reviewed.

Results: There was no significant difference in bowel cleansing between the groups. The LV-PEG+Asc group reported better patient acceptance and preference. There were no significant differences in the incidence or characteristics of the mucosal injuries between the two groups.

Conclusions: Compared with SD-PEG, LV-PEG+Asc exhibited equivalent bowel-cleansing efficacy and resulted in improved patient acceptance and preference. There was no significant difference in mucosal injury between SD-PEG and LV-PEG+Asc. Thus, the LV-PEG+Asc preparation could be used more effectively and easily for routine colonoscopies without risking significant mucosal injury.

Keywords: Ascorbic acid; Bowel preparation; Colonoscopy; Mucosal injury; Polyethylene glycols.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Ascorbic Acid / administration & dosage
  • Ascorbic Acid / adverse effects*
  • Cathartics / administration & dosage
  • Cathartics / adverse effects*
  • Colonoscopy / methods
  • Drug Therapy, Combination
  • Female
  • Humans
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / injuries*
  • Male
  • Middle Aged
  • Patient Compliance
  • Patient Satisfaction
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / adverse effects*
  • Preoperative Care / adverse effects*
  • Preoperative Care / methods
  • Surveys and Questionnaires
  • Vitamins / administration & dosage
  • Vitamins / adverse effects

Substances

  • Cathartics
  • Vitamins
  • Polyethylene Glycols
  • Ascorbic Acid