Polyethylene glycol combined with lactulose has better efficacy than polyethylene glycol alone in bowel preparation before colonoscopy: A meta-analysis

Zhang, Xiaofen; Chen, Yishu; Chen, Ye; Zhu, Wei; Tang, Chenxi; Lamm, Shelby; Li, Lan

doi:10.1016/j.clinsp.2023.100172

Cited by 5 publications

(1 citation statement)

References 20 publications

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“…When divided dosages are taken orally as opposed to one large dose given all at once, as is frequently done in clinical practice, a better quality of bowel preparation is achieved ( 5 ). Lactulose is commonly used in constipated populations, and in recent years, it has been explored for its bowel-preparing effects and further validated for its safety and efficacy ( 6 – 9 ). In a study that included 360 patients, 2 L of PEG was used in combination with 100 mL of lactulose for bowel preparation ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Lactulose vs Polyethylene Glycol for Bowel Preparation: A Single-Center, Prospective, Randomized Controlled Study Based on BMI

Wenqi,

Bei,

Yunrong

et al. 2023

Clinical and Translational Gastroenterology

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Objective: Colonoscopy is currently considered as one of the principal techniques to diagnose the colorectal diseases. Admittedly, qualified bowel preparation before colonoscopy is a premise for high-quality examination. Lower quality bowel preparation might seriously impede the visualization of the intestinal mucosa, resulting in missed and misdiagnosed intestinal lesions. Therefore, it is necessary to choose the appropriate oral laxative based on the guarantee of safety and efficacy. Methods: This prospective randomized controlled study was conducted to compare lactulose oral solution and polyethylene glycol electrolytes power (PEG) for bowel preparation using the following indicators: Boston bowel preparation scale(BBPS), bowel bubble score(BBS), the detection rate of adenoma and lesion, patients’ satisfaction and adverse effects. Our study investigated the suitability of 2 bowel preparation reagents for patients with different body mass indices mainly based on body mass index(BMI). Results: In the lactulose group there was a significant improvement in the quality of bowel preparation compared with those in the PEG group (P<0.05), especially in people with normal BMI and higher BMI. Compared with the PEG group, individuals in the lactulose group had a significantly higher adenoma detection rate (ADR) (50% vs 33.5%, P<0.05) and taste scores (8.82 vs 6.69, P＜0.05), as well as significantly fewer adverse reactions (6.5% vs 32.5%, P＜0.05). Conclusions: Lactulose oral solution is superior to PEG in terms of bowel preparation quality and taste, especially in normal BMI and higher BMI groups. It can be used clinically as a potential and promising bowel preparation agent in the future.

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Section: Introductionmentioning

confidence: 99%

Lactulose vs Polyethylene Glycol for Bowel Preparation: A Single-Center, Prospective, Randomized Controlled Study Based on BMI

Wenqi,

Bei,

Yunrong

et al. 2023

Clinical and Translational Gastroenterology

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Engineering Bacillus subtilis for highly efficient production of functional disaccharide lactulose from lactose

Zhang,

Xiong,

et al. 2024

International Journal of Biological Macromolecules

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High volume, low volume, or pills, which way should we go? a review of bowel preparation for colonoscopy

Haydel,

Xu,

Mansour

2023

Current Opinion in Gastroenterology

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Purpose of review Colorectal cancer (CRC) is the second leading cause of adult cancer-related deaths in the United States. Colonoscopy is the gold standard for CRC screening. Adequate bowel preparation prior to colonoscopy is essential for good visualization, which results in higher polyp detection rates and shorter procedural times. Achieving adequate preparation prior to colonoscopy is accomplished approximately 75% of the time. This review covers current recommendations and recent updates in bowel preparation for colonoscopy. Recent findings Split-dose bowel preparation is recommended, but recent studies show that same day, low-volume preparations are noninferior. Low-volume polyethylene glycol with electrolytes + ascorbic acid can achieve high-quality bowel preparation and 1-day, low-residue diets prior to colonoscopy, particularly prepackaged low-residue diets, can lead to better outcomes. Utilizing visual aids and artificial intelligence in the form of smartphone applications and quality prediction systems can also lead to higher rates of bowel preparation adequacy. Summary An individualized approach should be used to decide on the best preparation option for patients. Lower volume, same day preparations are available and lead to better patient tolerability and compliance, along with less stringent precolonoscopy diets. Smartphone applications and artificial intelligence will allow us to better educate and guide patients with regards to following preparation instructions.

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Polyethylene glycol combined with lactulose has better efficacy than polyethylene glycol alone in bowel preparation before colonoscopy: A meta-analysis

Cited by 5 publications

References 20 publications

Lactulose vs Polyethylene Glycol for Bowel Preparation: A Single-Center, Prospective, Randomized Controlled Study Based on BMI

Lactulose vs Polyethylene Glycol for Bowel Preparation: A Single-Center, Prospective, Randomized Controlled Study Based on BMI

Engineering Bacillus subtilis for highly efficient production of functional disaccharide lactulose from lactose

High volume, low volume, or pills, which way should we go? a review of bowel preparation for colonoscopy

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