A Meta-Analysis of Randomized Controlled Trials of Low-Volume Polyethylene Glycol plus Ascorbic Acid versus Standard-Volume Polyethylene Glycol Solution as Bowel Preparations for Colonoscopy

Xie, Qing; Chen, Linghui; Zhao, Fengqing; Zhou, Xin; Huang, Pengfei; Zhang, Lufei; Zhou, Dongkai; Wei, Jianfeng; Wang, Weilin; Zheng, Shusen

doi:10.1371/journal.pone.0099092

Cited by 73 publications

(62 citation statements)

References 53 publications

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“…The standard volume (4 L) of PEG is safe and has been used as the most effective formulation, but there is low compliance because of the large intake volume. 11 Low-volume (2 L) PEG-AA is more tolerable than the standard volume PEG and has comparable safety. 12,13 The decreased volumes needed for OSS and sodium picosulfate (less than 1 L) have increased their popularity.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Oral Sulfate Solution and Polyethylene Glycol Plus Ascorbic Acid on the Efficacy of Bowel Preparation

et al. 2020

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Background/Aims: The quality of bowel preparation is one of the quality indicators for colonoscopy. The aim of this study was to compare the efficacy of oral sulfate solution (OSS) and polyethylene glycol plus ascorbic acid (PEG-AA) for bowel preparation. Methods: The study involved 167 patients who underwent diagnostic colonoscopies. Inadequate bowel preparation was defined as any score of ≤1 in each colon section based on the Boston Bowel Preparation Scale. Multivariate logistic regression was used to compare the efficacy of OSS and PEG-AA. Subgroup analyses were performed based on patient characteristics. Results: Overall, 106 (63.5%) patients received OSS, and 61 (36.5%) patients received PEG-AA. The rate of inadequate bowel preparation was 12.3% in patients receiving OSS and 32.8% in patients receiving PEG-AA (p=0.001). OSS (odds ratio [OR] = 0.26; p=0.003) and morning examination (OR=0.11; p=0.038) were significantly associated with efficient bowel preparation. The efficacy of OSS compared with PEG-AA was only significant in patients ≥50 years of age vs. <50 years of age (OR=0.13; p=0.001 vs. OR=0.96; p=0.959) and female vs. male patients (OR=0.06; p=0.002 vs. OR=0.58; p=0.339). Conclusions: OSS was significantly more efficient for bowel preparation than PEG-AA, especially in patients ≥50 years of age and female patients. Morning examination led to a good quality of bowel preparation, irrespective of the preparation regimen. Clin Endosc 2020 Apr 24.

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Section: Introductionmentioning

confidence: 99%

Comparison of Oral Sulfate Solution and Polyethylene Glycol Plus Ascorbic Acid on the Efficacy of Bowel Preparation

et al. 2020

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“…Nonetheless, it is reported that 1 in 7 patients may not be compliant to bowel preparation regimen mainly due to the volume [19]. Improved results of preparation are achieved with better compliance, which has been shown to be related to decreased bowel preparation volume, palatability and regimen simplicity [2,17,[19][20][21]. We found that 100% of subjects who received low volume preparation nished their bowel preparation completely, in opposition to medium volume preparation (75%) and high volume preparation (77.8%).…”

Section: Discussionmentioning

confidence: 99%

Effect of Bowel Preparation Volume in Inpatient Colonoscopy. Results of a Prospective, Randomized, Comparative Pilot Study

Hernandez

Horsley‐Silva

Snyder

et al. 2020

Preprint

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Abstract Background: Inpatient status has been shown to be a predictor of poor bowel preparation for colonoscopy; however, the optimal bowel preparation regimen for hospitalized patients is unknown. Our aim was to compare the efficacy of bowel preparation volume size in hospitalized patients undergoing inpatient colonoscopy.Methods: This prospective, single blinded (endoscopist), randomized controlled trial was conducted as a pilot study at a tertiary referral medical center. Hospitalized patients undergoing inpatient colonoscopy were assigned randomly to receive a high, medium, or low-volume preparation. Data collection included colon preparation quality, based on the Boston Bowel Preparation Scale, and a questionnaire given to all subjects evaluating the ability to completely finish bowel preparation and adverse effects (unpleasant taste, nausea, and vomiting). Results: Twenty-five colonoscopies were performed in 25 subjects. Patients who received low-volume preparation averaged a higher mean total BBPS (7.4, SD 1.62), in comparison to patients who received high-volume (7.0, SD 1.41) and medium-volume prep (6.9, SD 1.55), P = 0.77. When evaluating taste a higher score meant worse taste. The low-volume group scored unpleasant taste as 0.6 (0.74), while the high-volume group gave unpleasant taste a score of 2.2 (0.97) and the medium-volume group gave a score of 2.1 (1.36), P < 0.01.Conclusion: In this pilot study we found that low-volume colon preparation may be preferred in the inpatient setting due its better rate of tolerability and comparable bowel cleanliness when compared to larger volume preparation, although we cannot overreach any definitive conclusion. Further more robust studies are required to confirm these findings.Trial registration: The Affect of Low-Volume Bowel Preparation for Hospitalized Patients Colonoscopies. Trial registration: NCT01978509 (terminated). Retrospectively registered on November 07, 2013.

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“…An adequate bowel preparation is largely dependent on effective colon cleansing, supplements and dietary restrictions [14]. A number of studies have currently focused on the effectiveness, safety, dosage and onset of action of laxatives [15][16][17].However, there are few studies on the effectiveness and patient tolerance of pre-colonoscopic diet for bowel preparation. Particularly, a few reports have compared the effects of clear liquid diet CLD and low-residue diet (LRD) in the pre-colonoscopy bowel preparation.…”

Section: Discussionmentioning

confidence: 99%

Comparing the influence of 1-day versus 3-day low-residue diet on bowel preparation for colonoscopy:a randomized controlled trial

Li¹,

Wang²,

Zhao³

et al. 2019

Preprint

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Backgroud :A low-residue diet (LRD) can potentially reduce the hunger of patients while improving compliance and tolerance,without compromising the quality of bowel preparation.This study investigated the effects of 1-day low-residue diets compared with 3-day for colonoscopic bowel preparation . Methods: Patients undergoing bowel preparation before colonoscopy were randomly divided into 1-day and 3-day LRD groups.Oral polyethylene glycol (PEG) electrolyte solution and simethicone were applied to all patients submitted to bowel preparation. The primary outcome measure included the quality of the bowel preparation rated by the Boston bowel preparation scale(BBPS), and the secondary measures included (i) cecal intubation time and withdrawal time, (ii) polyp detection rate, (iii) patient tolerance and (iv) the willingness of the patient to repeat the diet protocol thereafter. Results: No significant difference was detected in regards the quality of the bowel preparation when comparing the two groups, since the mean of BBPS score was 6.54 versus 6.55 in the 1- and 3-day LRD groups. The cecal intubation times,withdrawal times, polyp detection rates,and the patient tolerance (i.e.hunger-comfort score[1]) showed no significant difference between the 1- and 3-day LRD groups. However,overall satisfaction was higher with the 1-day LRD group than with the 3-day LRD group. Conclusion: The 1-day and 3-day low-residue diets showed no major effect on bowel preparation previously to colonoscopy, while the tolerance and satisfaction of patients were higher after 1-day low-residue diet. Trial registration: Clinical Trial Registry Identifier:ChiCTR1900025843.Date of registration:September 10,2019 “Retrospectively registered”. Key words: colonoscopy; bowel preparation; low-residue diet; duration; bowel-cleansing quality

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A Meta-Analysis of Randomized Controlled Trials of Low-Volume Polyethylene Glycol plus Ascorbic Acid versus Standard-Volume Polyethylene Glycol Solution as Bowel Preparations for Colonoscopy

Cited by 73 publications

References 53 publications

Comparison of Oral Sulfate Solution and Polyethylene Glycol Plus Ascorbic Acid on the Efficacy of Bowel Preparation

Comparison of Oral Sulfate Solution and Polyethylene Glycol Plus Ascorbic Acid on the Efficacy of Bowel Preparation

Effect of Bowel Preparation Volume in Inpatient Colonoscopy. Results of a Prospective, Randomized, Comparative Pilot Study

Comparing the influence of 1-day versus 3-day low-residue diet on bowel preparation for colonoscopy:a randomized controlled trial

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