Bisacodyl reduces the volume of polyethylene glycol solution required for bowel preparation

Adams, Warwick J.; Meagher, Allan P.; Lubowski, David Z.; King, D. W.

doi:10.1007/bf02048160

Cited by 156 publications

(122 citation statements)

References 10 publications

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“…With respect to diet, this was not highly restrictive as we chose a diet consisting of a low residue breakfast before 10 am on the day prior followed by clears up to 2.5 hours before colonoscopy. Though many physicians order a clear liquid diet for 24 hours, several studies support a less restrictive diet (4,17,18). Another consideration is that all but five colonoscopies were performed by one of the two endoscopists involved in this study.…”

Section: Discussionmentioning

confidence: 99%

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

Matro

Shnitser

Spodik

et al. 2010

American Journal of Gastroenterology

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Section: Discussionmentioning

confidence: 99%

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

Matro

Shnitser

Spodik

et al. 2010

American Journal of Gastroenterology

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“…To date, no bowel preparation meets all the requirements though important, advancements have been made with the low-volume [3][4][5][6][7] and split-dose bowel preparations. There is still a need to increase the overall acceptability of bowel preparation for colonoscopy and reduce the burden and impact on productivity and daily living with the ultimate objective to improve the attitude toward colonoscopy within the colon cancer screening programs [8] .…”

Section: Introductionmentioning

confidence: 99%

Same-day 2-L PEG-citrate-simethicone plus bisacodylvssplit 4-L PEG: Bowel cleansing for late-morning colonoscopy

Leone

Tamayo²,

Fiori³

et al. 2013

WJGE

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AIM:To evaluate the efficacy, tolerability, acceptability and feasibility of bisacodyl plus low volume polyethyleneglycol-citrate-simeticone (2-L PEG-CS) taken the same day as compared with conventional split-dose 4-L PEG for late morning colonoscopy. METHODS:Randomised, observer-blind, parallel group, comparative trial carried out in 2 centres. Out patients of both sexes, aged between 18 and 85 years, undergoing colonoscopy for diagnostic investigation, colorectal cancer screening or follow-up were eligible. The PEG-CS group received 3 bisacodyl tablets (4 tablets for patients with constipation) at bedtime and 2-L PEG-CS in the morning starting 5 h before colonoscopy. The control group received a conventional 4-L PEG formulation given as split regimen; the morning dose was taken with the same schedule of the low volume preparation. The Ottawa Bowel Preparation Scale (OBPS) score was used as the main outcome measure. RESULTS:A total of 164 subjects were enrolled and 154 completed the study; 78 in the PEG-CS group and 76 in the split 4-L PEG group. The two groups were comparable at baseline. The OBPS score in the PEG-CS group (3.09 ± 2.40) and in the PEG group (2.39 ± 2.55) were equivalent (difference +0.70; 95%CI: -0.09-1.48). This was confirmed by the rate of successful bowel cleansing in the PEG-CS group (89.7%) and in the PEG group (92.1%) (difference -2.4%; 95%CI: -11.40-6.70). PEG-CS was superior in terms of mucosa visibility compared to PEG (85.7% vs 72.4%, P = 0.042). There were no significant differences in caecum intubation rate, time to reach the caecum and withdrawal time between the two groups. The adenoma detection rate was similar (PEG-CS 43.6% vs PEG 44.7%). No serious adverse events occurred. No difference was found in tolerability of the bowel preparations. Compliance was equal in both groups: more than 90% of subjects drunk the whole solution. Willingness to repeat the same bowel preparations was about 90% for both regimes. CONCLUSION:Same-day PEG-CS is feasible, effective as split-dose 4-L PEG for late morning colonoscopy and does not interfere with work and daily activities the day before colonoscopy. Key words: Bowel preparation; Polyethyleneglycol; Simethicone; Ottawa Bowel Preparation Scale; Colonoscopy Core tip: The timing of bowel preparation is fundamental for high quality colonoscopy and also for patient satisfaction. Split-dose preparation improves the rate of adequate cleansing and patient compliance. This study shows that the same-day low volume polyethyleneglycol-citrate-simeticone (PEG-CS) plus bisacodyl tablets is feasible, and as effective as split 4-L PEG. The low volume bowel preparation taken the same day of the exam may be an attractive option for late morning September 16, 2013|Volume 5|Issue 9|

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“…In a related study that compared split dosing of MC-SP with day-before dosing of a PEG plus bisacodyl preparation, patients receiving the SP-based preparation had better colon cleansing and reported better tolerance of the preparation [41,43] . Administering enemas, bisacodyl, or metoclopramide in addition to the standard dose of PEG has not been shown to improve the quality of the preparation or the patient's tolerance, so it is not recommended [44,45] . However, bisacodyl does improve the effectiveness of the preparations of low-volume PEG (2 L) [46] .…”

Section: Resultsmentioning

confidence: 99%

Achieving the best bowel preparation for colonoscopy

Parra‐Blanco¹,

Ruiz²,

Álvarez-Lobos³

et al. 2014

WJG

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Bowel preparation is a core issue in colonoscopy, as it is closely related to the quality of the procedure. Patients often find that bowel preparation is the most unpleasant part of the examination. It is widely accepted that the quality of cleansing must be excellent to facilitate detecting neoplastic lesions. In spite of its importance and potential implications, until recently, bowel preparation has not been the subject of much study. The most commonly used agents are high-volume polyethylene glycol (PEG) electrolyte solution and sodium phosphate. There has been some confusion, even in published meta-analyses, regarding which of the two agents provides better cleansing. It is clear now that both PEG and sodium phosphate are effective when administered with proper timing. Consequently, the timing of administration is recognized as one of the central factors to the quality of cleansing. The bowel preparation agent should be administered, at least in part, a few hours in advance of the colonoscopy. Several low volume agents are available, and either new or modified schedules with PEG that usually improve tolerance. Certain adjuvants can also be used to reduce the volume of PEG, or to improve the efficacy of other agents. Other factors apart from the choice of agent can improve the quality of bowel cleansing. For instance, the effect of diet before colonoscopy has not been completely clarified, but an exclusively liquid diet is probably not required, and a low-fiber diet may be preferable because it improves patient satisfaction and the quality of the procedure. Some patients, such as diabetics and persons with heart or kidney disease, require modified procedures and certain precautions. Bowel preparation for pediatric patients is also reviewed here. In such cases, PEG remains the most commonly used agent. As detecting neoplasia is not the main objective with these patients, less intensive preparation may suffice. Special considerations must be made for patients with inflammatory bowel disease, including safety and diagnostic issues, so that the most adequate agent is chosen. Identifying neoplasia is one of the main objectives of colonoscopy with these patients, and the target lesions are often almost invisible with white light endoscopy. Therefore excellent quality preparation is required to find these lesions and to apply advanced methods such as chromoendoscopy. Bowel preparation for patients with lower gastrointestinal bleeding represents a challenge, and the strategies available are also reviewed here. Core tip: Bowel preparation for colonoscopy is a central issue related to the quality of the procedure. There are different agents for bowel preparation that can be administered with different schedules. We review the most commonly used agents, as well as new agents and combinations. Moreover, certain considerations should be taken into account for special populations in order to improve safety, efficacy and tolerance. Regimens for bowel preparation in special situations are discussed, such as for pedi...

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Bisacodyl reduces the volume of polyethylene glycol solution required for bowel preparation

Abstract: Bowel preparation with bisacodyl and 2 liters of polyethylene glycol is more acceptable to patients than a 4-liter regimen and is equally effective in cleansing the colon.

Cited by 156 publications

References 10 publications

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

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

Same-day 2-L PEG-citrate-simethicone plus bisacodylvssplit 4-L PEG: Bowel cleansing for late-morning colonoscopy

Achieving the best bowel preparation for colonoscopy

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