Publication details

A head-to-head comparison of 4-L polyethylene glycol and low-volume solutions before colonoscopy: which is the best? A multicentre, randomized trial

Authors

KOJECKÝ Vladimír MATOUS J. KEIL R. DASTYCH Milan KROUPA Radek ZADOROVA Z. VARGA M. DOLINA Jiří KMENT M. HEP Aleš

Year of publication 2017
Type Article in Periodical
Magazine / Source International Journal of Colorectal Disease
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1007/s00384-017-2901-x
Field Other medical specializations
Keywords Ascorbic acid; Colonoscopy; Magnesium citrate; Picosulfate sodium; Polyethylene glycol
Description Purpose: The purpose of this study is to compare the efficacy and tolerability of polyethylene glycol (PEG) to sodium picosulfate/magnesium citrate (SPMC) and low-volume polyethylene glycol/ascorbic acid (PEGA) in a single- or split-dose regimen for colonoscopy bowel preparation. Methods: This was a prospective, randomized, endoscopist-blinded, multicentre study. Outpatients received either PEG or SPMC or PEGA in a single or a split dose before the colonoscopy. Quality and tolerability of the preparation and complaints during preparation were recorded. Results: Nine hundred seventy-three patients were analysed. Satisfactory bowel cleansing (Aronchick score 1 + 2) was more frequent when a split dose was used irrespective of the solution type (PEG 90.1 vs 68.8%, PEGA 86.0 vs 71.6%, SPMC 84.3 vs 60.2%, p < 0.001). SPMC was the best tolerated followed by PEGA (p < 0.006) and PEG as the worst (p < 0.001). Tolerability did not correlate with the regimen and amount of the solution used. Female gender is associated with a higher incidence of nausea, vomiting and pain (p < 0.029). Conclusions: Both PEG, PEGA and SPMC are fully comparable in terms of colonic cleansing when used in similar regimens. The split-dose preparation is more effective in all agents. SPMC and PEGA are better tolerated than PEG. The preparation regimen and/or the volume do not affect tolerability.

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