Safety and Efficacy of a Same-Day Low-Volume 1 L PEG Bowel Preparation in Colonoscopy for the Elderly People and People with Renal Dysfunction

Dig Dis Sci. 2016 Nov;61(11):3229-3235. doi: 10.1007/s10620-016-4262-7. Epub 2016 Aug 3.

Abstract

Introduction: A same-day low-volume 1 L polyethylene glycol (PEG) for bowel preparation before colonoscopy was developed to improve patients' compliance. We aimed to evaluate the efficacy and safety of this regimen especially for the elderly and patients with renal dysfunction.

Methods: All consecutive patients who underwent colonoscopy in our center from November 2014 to September 2015 were included. Patients undertook a low-residue diet with 10 mL sodium picosulfate 1 day before colonoscopy. Subsequently, they had 1 L low-volume PEG (MoviPrep) and 0.5 L water 4 h before the examination. Clinical outcomes, including cleansing level using the Boston bowel preparation score (BBPS), in the elderly and special-elderly (65-79 and ≥80 years old) were analyzed and compared with the non-elderly (18-64 years old). Additionally, patients with renal dysfunction were analyzed with respect to both complications and changes in blood parameters.

Results: A total of 5427 patients (mean age: 64.5 ± 13.8) were analyzed. The rate of BBPS ≥ 6 in the elderly (2761 patients), special-elderly (565 patients), and non-elderly (2101 patients) was 94.1, 91.8, and 94.6 %, respectively. In the special-elderly, the rate of renal dysfunction was 14.8 %, and no severe complications were detected after colonoscopy. Additionally, there were no severe complications in 86 patients with renal dysfunction, though elevation of hematocrit was shown after intake of 1 L PEG (before, 36.7 ± 6.1 vs. after, 39.0 ± 5.7, P = 0.006).

Conclusions: Our study shows the safety and efficacy of same-day low-volume 1 L PEG bowel preparation in colonoscopy for the elderly and patients with renal dysfunction.

Keywords: Ascorbic acid; Bowel preparation; Colonoscopy; Low-volume PEG; RENAL dysfunction; The elderly.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cathartics / adverse effects*
  • Cathartics / therapeutic use
  • Citrates / adverse effects
  • Citrates / therapeutic use
  • Colonoscopy / methods*
  • Creatinine / blood
  • Female
  • Hematocrit
  • Humans
  • Male
  • Middle Aged
  • Organometallic Compounds / adverse effects
  • Organometallic Compounds / therapeutic use
  • Picolines / adverse effects
  • Picolines / therapeutic use
  • Polyethylene Glycols / adverse effects*
  • Polyethylene Glycols / therapeutic use
  • Renal Dialysis
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / therapy
  • Retrospective Studies
  • Water-Electrolyte Imbalance / blood
  • Water-Electrolyte Imbalance / chemically induced*
  • Water-Electrolyte Imbalance / epidemiology
  • Young Adult

Substances

  • Cathartics
  • Citrates
  • MoviPrep
  • Organometallic Compounds
  • Picolines
  • Polyethylene Glycols
  • Creatinine
  • picosulfate sodium