Endoscopy 2007; 39(7): 616-619
DOI: 10.1055/s-2007-966434
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Quality and effect of single dose versus split dose of polyethylene glycol bowel preparation for early-morning colonoscopy

J.  S.  Park1 , C.  I.  Sohn1 , S.  J.  Hwang1 , H.  S.  Choi1 , J.  H.  Park1 , H.  J.  Kim1 , D.  I.  Park1 , Y.  K.  Cho1 , W.  K.  Jeon1 , B.  I.  Kim1
  • 1Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
Further Information

Publication History

submitted 12 July 2006

accepted after revision 28 December 2006

Publication Date:
05 July 2007 (online)

Background and study aims: The conventional procedure of ingestion of an entire dose of polyethylene glycol solution on the day before early-morning colonoscopy may result in poor bowel preparation. The aim of this study was to evaluate the efficacy and effect of a split-dose ingestion of polyethylene glycol for early-morning colonoscopy. Methods: A total of 303 age- and sex-matched consecutive individuals presenting for medical check-ups were randomly assigned to receive either 4 L of polyethylene glycol solution with a soft diet on the day before colonoscopy (n = 152; group A), or 3 L of polyethylene glycol solution with a soft diet on the preceding day and then 1 L of the solution on the day of colonoscopy (n = 151; group B). The quality of bowel preparation was evaluated using the Ottawa scale, and the time to cecal intubation and the technical difficulty during the procedure were also recorded. Results: There was no difference in compliance between group A (single-dose) and group B (split-dose). The quality of bowel preparation was better in group B compared with group A. When the participants were categorized according to compliance (good compliance, 116 in group A, 119 in group B; poor compliance, 36 in group A, 32 in group B), the quality of the bowel preparation had a higher score in the good compliance compared with the poor compliance group, and in group B this difference was usually significant. Conclusions: Split-dose bowel preparation with polyethylene glycol solution provided a better quality preparation than the conventional method for patients undergoing early-morning colonoscopy.

References

  • 1 Vanner S J, MacDonald P H, Paterson W G. et al . A randomized prospective trial comparing oral sodium phosphate with standard polyethylene glycol-based lavage solution (Golytely) in the preparation of patients for colonoscopy.  Am J Gastroenterol. 1990;  85 422-427
  • 2 Marshall J B, Pineda J J, Barthel J S, King P D. Prospective, randomized trial comparing sodium phosphate solution with polyethylene glycol-electrolyte lavage for colonoscopy preparation.  Gastrointest Endosc. 1993;  39 631-634
  • 3 Lieberman D A, Ghormley J, Flora K. Effect of oral sodium phosphate colon preparation on serum electrolytes in patients with normal serum creatinine.  Gastrointest Endosc. 1996;  43 467-469
  • 4 Zwas R F, Cirillo N W, El-Serang H B, Eisen R N. Colonic mucosal abnormalities associated with oral sodium phosphate solution.  Gastrointest Endosc. 1996;  43 463-466
  • 5 Hixson L J. Colorectal ulcers associated with sodium phosphate catharsis.  Gastrointest Endosc. 1995;  42 101-102
  • 6 Davis G R, Santa Ana C A, Morawski S G, Fordtran J S. Development of a lavage solution assdociated with minimal water and electrolyte absorption or secretion.  Gastroenterology. 1980;  78 991-995
  • 7 Beck D E, Hartford F J, DiPalma J A, Brady C E. Bowel cleansing with polyethylene glycol electrolyte lavage solution.  South Med J. 1985;  78 1414-1416
  • 8 Rostom A, Jolicoeur E. Validation of a new scale for the assessment of bowel preparation quality.  Gastrointest Endosc. 2004;  59 482-486
  • 9 Church J M. Effectiveness of polyethylene glycol antegrade gut lavage bowel preparation for colonoscopy - timing is the key!.  Dis Colon Rectum. 1998;  41 1223-1225
  • 10 Thomson A, Naidoo P, Crotty B. Bowel preparation for colonoscopy: a randomized prospective trail comparing sodium phosphate and polyethylene glycol in a predominantly elderly population.  J Gastroenterol Hepatol. 1996;  11 103-107
  • 11 Clarkston W K, Tsen T N, Dies D F. et al . Oral sodium phosphate versus sulfate-free polyethylene glycol electrolyte lavage solution in outpatient preparation for colonoscopy: a prospective comparison.  Gastrointest Endosc. 1996;  43 42-48
  • 12 Pontone P, Bogliolo G, Pietropaolo V, Pallotto P. Polyethylene glycol versus sodium phosphate: comparison of 2 preparations for colonoscopy.  G Chir. 1996;  17 128-131
  • 13 Marshall J B, Barthel J S, King P D. Short report: prospective, randomized trial comparing a single dose sodium phosphate regimen with polyethylene glycol-electrolyte lavage for colonoscopy preparation.  Aliment Pharmacol Ther. 1993;  7 679-682
  • 14 Toledo T K, DiPalma J A. Review article: colon cleansing preparation for gastrointestinal procedures.  Aliment Pharmacol Ther. 2001;  15 605-611
  • 15 Aoun E, Abdul-Baki H, Azar C. et al . A randomized single-blind trial of split-dose polyethylene glycol-electrolyte solution without dietary restriction compared with whole dose polyethylene glycol-electrolyte solution with dietary restriction for colonoscopy preparation.  Gastrointest Endosc. 2005;  62 213-218
  • 16 Adams W J, Meagher A P, Lubowski D Z, King D W. Bisacodyl reduces the volume of polyethylene glycol solution required for bowel preparation.  Dis Colon Rectum. 1994;  37 229-233
  • 17 Sharma V K, Chockalingham S K, Ugheoke E A. et al . Prospective, randomized, controlled comparison of the use of polyethylene glycol electrolyte lavage solution in four-liter versus two-liter volumes and pretreatment with either magnesium citrate or bisacodyl for colonoscopy preparation.  Gastrointest Endosc. 1998;  47 167-171

C. I. Sohn, MD

Department of Internal Medicine
Kangbuk Samsung Hospital

108, Pyeong-dong, Jongno-gu
Seoul
Korea, 110-746

Fax: +82-2-20012610

Email: chongil.sohn@samsung.com

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