Efficacy and tolerability of low-volume (2 L) versus single-(4 L) versus split-dose (2 L+2 L) polyethylene glycol bowel preparation for colonoscopy: Randomized clinical trial

Background and AimTo compare the efficacy and tolerability of a low-volume (2-L) polyethylene glycol (PEG) regimen for colonoscopy compared to single (4-L) or split-dose (2-L+2-L) regimens. MethodsIn-hospital patients who were candidates for colonoscopy were randomly assigned to: group 1 single-dose (PEG 4L the day before the study, n=60); group 2: split-dose (2L the day before and 2L on the day of the procedure, n=61); and group 3: low-volume 2-L PEG solution (the day of the procedure, n=59). A blinded evaluation of the quality of colonic preparation was assessed by the Boston bowel preparation scale. ResultsSatisfactory bowel preparation of the right colon was more frequently reported for group 3 than for group 1 (70% vs 53%, P=0.045), in the transverse colon it was 82% versus 69% (P=0.032), and on the left side of the colon it was 80% versus 67.7% (P=0.028). Compared to group 2, satisfactory bowel preparation in group 3 was similar in the transverse colon and left colon. Nausea, vomiting, and abdominal discomfort were less frequent in patients of group 3. Patients in group 3 had fewer sleep disorders and fewer hours of sleep loss compared to patients in the other groups. ConclusionsPreparation with 2L caused less abdominal discomfort and fewer sleep disorders. The split dose had a better quality of preparation in the right colon. Both preparations were clearly better than the 4-L preparation.