A randomized single-blind trial of whole versus split-dose polyethylene glycol-electrolyte solution for colonoscopy preparation

Efficacy of Morning-Only Compared With Split-Dose Polyethylene Glycol Electrolyte Solution for Afternoon Colonoscopy: A Randomized Controlled Single-Blind Study

“…Despite more than 14 million colonoscopies being performed each year, the historic rates for adequate cleansing are unacceptably low and range from 70-82% (10)(11)(12)(13). Recent studies have shown that ingesting at least part of the purgative on the day of colonoscopy and coordinating the final dose of purgative with the start time of colonoscopy is more likely to result in adequate colon cleansing (2)(3)(4)(5). Generally, this is accomplished by splitting the purgative between the evening prior and the morning of colonoscopy.…”

“…Both groups of patients in the study presented herein were asked to complete the second dose of PEG-ELS 4 hours before their scheduled procedure time. Aspiration, though rare, is serious and has not been reported in several studies that have specifically evaluated PEG-ELS dosing on the day of colonoscopy (2)(3)(4)(5)8). Large published series of patients receiving propofol-based anesthesia for endoscopy have found aspiration to be a rare event.…”

“…Day-of-colon dosing can be achieved through two strategies -split (PM/AM) dosing where part of the purgative is administered the night prior to colonoscopy and the remainder within ~6 hours of the procedure, and morning-only (AM-only) dosing where the entire prep is taken on the day of colonoscopy (2)(3)(4)(5). By linking the final dose of purgative to the timing of colonoscopy, a greater chance of adequate cleansing is assured regardless of the time of colonoscopy.…”

Quality assurance in colonoscopy for colorectal cancer diagnosis

“…A good preparation is essential to visualize the entire colon. Split-dose polyethylene glycol-electrolyte (PEG) is recommended (34)(35)(36).…”

White Diet with split‐dose Picosalax is preferred, better tolerated, and non‐inferior to day‐before clear fluids with polyethylene glycol plus sodium picosulfate‐magnesium citrate for morning colonoscopy: A randomized, non‐inferiority trial

“…Combination preparations with PEG plus SPMC may be better tolerated than high‐volume PEG alone8 and are standard practice in many Australian hospitals and endoscopy centers. Several randomized controlled trials and a meta‐analysis confirm that splitting the bowel preparation dose between the day prior and the day of the procedure results in both improved bowel cleansing and patient tolerance compared with day‐prior regimens 9, 10, 11, 12…”