Randomized controlled trial: Standard versus supplemental bowel preparation in patients with Bristol stool form 1 and 2

PLoS One. 2017 Feb 27;12(2):e0171563. doi: 10.1371/journal.pone.0171563. eCollection 2017.

Abstract

Background: Bristol stool form 1 and 2 is an important predictor of inadequate bowel preparation.

Aim: To evaluate the efficacy of supplemental preparation in bowel cleansing quality among patients with Bristol stool form 1 and 2, as well as the feasibility of tailored bowel preparation guided by Bristol stool form scale.

Methods: Patients with Bristol stool form 1 and 2 from 3 Chinese tertiary hospitals randomly received either 2 L PEG-ELP (group A) or 10 mg bisacodyl plus 2 L PEG-ELP (group B); patients with Bristol stool form 3 to 7 received 2 L PEG-ELP (group C) for bowel preparation. The primary endpoint is the rate of adequate bowel reparation for the whole colon. The adequate bowel preparation rate for separate colon segments, the polyp detection rate (PDR), tolerability, acceptability, sleeping quality and compliance were evaluated as secondary endpoints.

Results: 700 patients were randomized. In per-protocol analysis, patients in group B attained significantly higher successful preparation rate than group A (88.7% vs. 61.2%, p<0.001) and similar with group C (88.7% vs. 85.0%, p = 0.316). The PDR in group B was significantly higher than group A (43.2% vs. 25.7%, p<0.001). Acceptability was much higher in group B and C.

Conclusions: 10 mg bisacodyl plus 2 L PEG-ELP can significantly improve both bowel preparation quality and PDR in patients with Bristol stool form 1 and 2. Bristol stool form scale may be an easy and efficient guide for tailored bowel preparation before colonoscopy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Bisacodyl / administration & dosage
  • Cathartics / therapeutic use*
  • China
  • Colonoscopy / methods*
  • Feces
  • Female
  • Humans
  • Intestines / drug effects*
  • Intestines / physiology
  • Male
  • Middle Aged
  • Patient Compliance
  • Patient Satisfaction
  • Polyps / diagnosis
  • Prospective Studies
  • Tertiary Care Centers
  • Treatment Outcome
  • Young Adult

Substances

  • Cathartics
  • Bisacodyl

Grants and funding

The study is supported by National Natural Science Foundation of China (Grant No. 81330012), www.nsfc.gov.cn/publish/portal1/. The author YQL received this funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.