2 L PEG plus ascorbic acid versus 4 L PEG plus simethicon for colonoscopy preparation: a randomized single-blind clinical trial

Surg Laparosc Endosc Percutan Tech. 2013 Jun;23(3):276-80. doi: 10.1097/SLE.0b013e31828e389d.

Abstract

Background: The 2 L polyethylene glycol (PEG) lavage solution has been proved to be similarly safe and effective as 4 L PEG formulations, in spite of the reduced volume.

Objective: To compare low-volume PEG-based solution combined with ascorbic acid with high-volume PEG-based solution combined with simethicon in terms of efficacy and patient tolerability.

Methods: This was a single-blind prospective randomized trial. Patients were randomized to receive either 2 L PEG plus ascorbic acid (PEG+Asc) or 4 L PEG plus simethicon (PEG+Sim). The primary endpoint was overall colon cleansing evaluation, assessed by blinded investigators using Aronchick score. Secondary end points included patient compliance and tolerability and adverse events.

Results: Sixty patients received PEG+Asc and 60 received PEG+Sim. Overall bowel cleansing score was considered adequate in 81.67% of the PEG+Asc and 80% of the PEG+Sim groups, respectively. Excellent and good ratings were recorded in 11.6% and 38.3% receiving PEG+Asc as compared with 26.6% and 23.3% of patients receiving PEG+Sim. Patient tolerability and safety were similar with both the preparations.

Conclusions: According to our data, low-volume PEG+Asc has comparable efficacy, safety, and tolerability as high-volume PEG+Sim; therefore, it can be considered as a good alternative solution for bowel preparation. More improvements are necessary to achieve the target of a perfect preparation.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antioxidants / administration & dosage
  • Ascorbic Acid / administration & dosage*
  • Colonoscopy / methods*
  • Drug Combinations
  • Emollients / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance
  • Patient Satisfaction
  • Pharmaceutical Solutions / administration & dosage
  • Polyethylene Glycols / administration & dosage*
  • Prospective Studies
  • Simethicone / administration & dosage*
  • Single-Blind Method
  • Surveys and Questionnaires
  • Therapeutic Irrigation / methods*
  • Young Adult

Substances

  • Antioxidants
  • Drug Combinations
  • Emollients
  • Pharmaceutical Solutions
  • Polyethylene Glycols
  • Simethicone
  • Ascorbic Acid