Randomized controlled trial of low-volume bowel preparation agents for colonic bowel preparation: 2-L polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate

Jeon, Seong Ran; Kim, Hyun Gun; Lee, Ji Seong; Kim, Jin–Oh; Lee, Tae Hee; Cho, Jun-Hyung; Kim, Yong Hun; Cho, Joo Young; Lee, Joon Seong

doi:10.1007/s00384-014-2066-9

Cited by 31 publications

(54 citation statements)

References 32 publications

(50 reference statements)

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“…Meanwhile, recent Korean studies have successfully demonstrated that other reduced-volume preparation methods, such as sodium picosulfate with magnesium citrate (SP/MC), show similar efficacy compared to 2-L of the PEG with Asc. [16] To this end, the present investigators hypothesized that preparation with an even further reduction in volume by Bis addition may demonstrate similar efficacy as the 2-L PEG/Asc solution. Furthermore, the combination of 1-L PEG/Asc + Bis, a relatively low-volume preparation, has not been tested previously.…”

Section: Introductionmentioning

confidence: 94%

Comparable Efficacy of a 1-L PEG and Ascorbic Acid Solution Administered with Bisacodyl versus a 2-L PEG and Ascorbic Acid Solution for Colonoscopy Preparation: A Prospective, Randomized and Investigator-Blinded Trial

Kwon

Lee

et al. 2016

PLoS ONE

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BackgroundTwo liters of polyethylene glycol (PEG) solution administered with ascorbic acid (Asc) can provide efficacy similar to that of a 4-L PEG solution for colonoscopy preparation. In addition, oral bisacodyl (Bis) has been shown to reduce the volume of PEG needed for a bowel preparation with comparable efficacy. This study aimed to compare the efficacy, tolerability and safety of a 2-L PEG solution mixed with Asc versus the combination of Bis, Asc and a 1-L PEG solution.MethodsThis was a prospective, randomized, multi-centre, single-blind, non-inferiority trial. Participants who were scheduled for colonoscopy were included and randomized to receive either 2-L PEG and Asc (2L PEG/Asc group) or 1-L PEG, Asc and 20 mg Bis (1L PEG/Asc + Bis group). The quality of bowel preparation was assessed using the Boston Bowel Preparation Scale. Data regarding tolerance, compliance and adverse events were also gathered.ResultsA total of 187 participants were analyzed; 96 were allocated to the 2L PEG/Asc group and 91 to the 1L PEG/Asc + Bis group. Bowel preparation was adequate in 87.5% (84/96) of patients in the 2L PEG/Asc group and 94.5% of the 1L PEG/Asc + Bis group (86/91, p = 0.10). There was no significant difference between the two groups with respect to compliance, tolerability or safety. The patients allocated to the 1L PEG/Asc + Bis group expressed more willingness to repeat the procedure than patients in the 2L PEG/Asc group (p = 0.01).ConclusionsBowel preparation with Bis and a 1-L PEG/Asc solution is as effective, well-tolerated, and safe as a 2-L PEG/Asc solution.Trial RegistrationClinicalTrials.gov NCT 01745835; Clinical Research Information Service (CRiS) KCT0000708

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Section: Introductionmentioning

confidence: 94%

Comparable Efficacy of a 1-L PEG and Ascorbic Acid Solution Administered with Bisacodyl versus a 2-L PEG and Ascorbic Acid Solution for Colonoscopy Preparation: A Prospective, Randomized and Investigator-Blinded Trial

Kwon

Lee

et al. 2016

PLoS ONE

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“…Direct controlled, randomized, head-to-head comparisons of bowel preparation agents are rare. For example, the comparisons between 2-liter polyethylene glycol with ascorbic acid vs. sodium picosulfate with magnesium citrate showed no differences in the cleaning outcome [41]. …”

Section: Factors Influencing the Adrmentioning

confidence: 99%

Endoscopic Improvement of the Adenoma Detection Rate during Colonoscopy - Where Do We Stand in 2015?

Floer

Meister²

2016

Digestion

238

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Background: The presence of colorectal adenomas is considered a major risk factor for colorectal cancer development. The implementation of screening colonoscopy programs in the Western world has led to a substantial reduction of colorectal cancer death. Many efforts have been made to reduce the adenoma miss rates by the application of new endoscopic devices and techniques for better adenoma visualization. Summary: This special review gives the readership an overview of current endoscopic innovations that can aid in the increase of the adenoma detection rate (ADR) during colonoscopy. These innovations include the use of devices like EndoCuff® and EndoRings® as well as new technical equipment like third-eye endoscope® and full-spectrum endoscopy (FUSE®). Key Message: Technical improvements and newly developed accessories are able to improve the ADR. However, additional costs and a willingness to invest into potentially expensive equipment might be necessary. Investigator-dependent skills remain the backbone in the ADR detection.

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“…Another meta-analysis has shown that split-dose preparations provide with significantly better colon cleansing than daybefore preparations, either of PEG, sodium phosphate, or SPMC [16]. SPMC, either two or three sachets, and lowvolume PEG with ascorbic acid have been also compared, both being administered in split regimens, resulting in similar efficacy for bowel cleansing and superior acceptability for SPMC [17,18]. The results of these studies using same-day preparations of bowel cleansing solutions or a split-dose regimen suggest that the timing of the administration rather than the compound used for bowel cleansing is important for the quality of the preparation and it is clear that bowel preparation quality varies inversely with the duration of the interval between the last dose of the bowel preparation agent and the start of the colonoscopy [19].…”

Section: Discussionmentioning

confidence: 97%

A randomized trial to compare the efficacy and tolerability of sodium picosulfate-magnesium citrate solution vs. 4 L polyethylene glycol solution as a bowel preparation for colonoscopy

Muñoz-Navas

Calleja

Payeras

et al. 2015

Int J Colorectal Dis

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Randomized controlled trial of low-volume bowel preparation agents for colonic bowel preparation: 2-L polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate

Abstract: Both 2-L PEG/Asc and SP/MC had adequate bowel cleansing efficacy to satisfy PDR and ADR as quality indicator and had showed similar tolerability.

Cited by 31 publications

References 32 publications

Comparable Efficacy of a 1-L PEG and Ascorbic Acid Solution Administered with Bisacodyl versus a 2-L PEG and Ascorbic Acid Solution for Colonoscopy Preparation: A Prospective, Randomized and Investigator-Blinded Trial

Comparable Efficacy of a 1-L PEG and Ascorbic Acid Solution Administered with Bisacodyl versus a 2-L PEG and Ascorbic Acid Solution for Colonoscopy Preparation: A Prospective, Randomized and Investigator-Blinded Trial

Endoscopic Improvement of the Adenoma Detection Rate during Colonoscopy - Where Do We Stand in 2015?

A randomized trial to compare the efficacy and tolerability of sodium picosulfate-magnesium citrate solution vs. 4 L polyethylene glycol solution as a bowel preparation for colonoscopy

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