Residual Gastric Volume After Bowel Preparation With Polyethylene Glycol for Elective Colonoscopy

Abstract

PEG bowel preparations increase RGV mildly, but seem to have no clinical significance. These results support the current fasting guidelines for colonoscopy.

Split‐dose bowel preparation with polyethylene glycol for colonoscopy performed under propofol sedation. Is there an optimal timing?

“…Recently, Cheng et al found a mean RGV of 28.5 ± 23.2 mL in 330 low‐to‐medium risk patients undergoing a same‐day EGD and colonoscopy using a PEG‐based split‐dose bowel preparation with a runway time of 3.4 ± 1.0 h. The RGV did not differ in patients with 2, 3 and ≥3 h runway time, using a total of 3 L of PEG‐ containing bowel preparation. The mean RGV in 165 patients with a runway time of 2–3 h was 27 ± 19.4 mL . Unlike the later study, our data showed a statistically significant increase in RGV when the runway time was ≤3 h. However, this finding needs to be interpreted with caution as there were only 17 patients in this group and such a magnitude of difference is unlikely to be clinically significant.…”

“…Our study showed a mean RGV of 17.7 AE 19.2 mL, with a mean runway time of 5.8 AE 2.0 h, which is similar to that reported in multiple studies (20-25 mL), leading to major society guideline recommendations of a clear liquid intake of 200 mL/h for up to 2 h before the induction of anesthesia. 38 37 Unlike the later study, our data showed a statistically significant increase in RGV when the runway time was ≤3 h. However, this finding needs to be interpreted with caution as there were only 17 patients in this group and such a magnitude of difference is unlikely to be clinically significant.…”

“…Excluding PPIs, other medications have not been found to correlate with RGV. The effect of medications including PPIs is likely to be small, given that our data are similar to others where the medication intake was recorded, and this is unlikely to affect the validity of the results . The correlation between age and RGV independent of PPI therapy was also noted in a similar context …”

“…The effect of medications including PPIs is likely to be small, given that our data are similar to others where the medication intake was recorded, and this is unlikely to affect the validity of the results. [35][36][37]48 The correlation between age and RGV independent of PPI therapy was also noted in a similar context. 44 Our study adds to the accumulating evidence that favors the intake of 1 L bowel preparation regimen containing PEG close to deep sedation.…”

“…A limited number of studies including 659 patients in total have shown that, the RGV after a mean runway time of 2-5 h did not differ significantly from that resulted from a longer runway time after splitdose colonoscopy preparation. [35][36][37] However, the optimal time between the last colonoscopy preparation agent intake and sedation for colonoscopy has not been defined and remains a matter of debate.…”