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☆,☆☆,★
Section snippets
Patients and Methods
This was a prospective, randomized, single-blinded, controlled trial. All consecutive patients referred for outpatient colonoscopy were considered eligible for the study. Hospitalized patients undergoing colonoscopy, and those with previous colon or rectal surgery were excluded. Patients were randomly chosen to receive one of three preparations. “Prep 1” consisted of ingestion of 4 L of PEG-ELS (Colyte; Schwarz Pharma, Inc., Milwaukee, Wis.) alone starting at 4 p.m. on the day before the
Results
One hundred fifty consecutive patients (148 men, mean age 62 years ± 11.4 [SD], range 28 to 85 years) were enrolled. Fifty-nine patients were randomized to Prep 1, 45 to Prep 2, and 46 to Prep 3. Patients were well matched with respect to age, race, prior abdominal surgery, prior colonoscopy, indications for colonoscopy, and findings at colonoscopy. All patients tolerated the preparations and examination well. Sleep on the night of the preparation was described as “same as usual” by 76.3%,
Discussion
Colonoscopy is customarily performed in an outpatient setting under conscious sedation. Its success depends on the adequacy of preparation of the colon. Either PEG-ELS or sodium phosphate solution is usually used for this purpose. Both preparations have their limitations. The large volume of PEG-ELS required is not well tolerated by some patients, thereby resulting in inadequate intake and poor quality of preparation.11 Efforts to improve acceptability have mainly focused on enhancing the taste
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Bowel preparation before colonoscopy
2015, Gastrointestinal EndoscopyCitation Excerpt :The only FDA-approved regimen of low-volume 2-L PEG-ELS combined with bisacodyl was discontinued by the manufacturer in 2013. Two studies found that magnesium citrate used as an adjunct to PEG-ELS allowed less PEG-ELS solution (2 L) to be used to achieve adequate cleansing.109,112 The use of magnesium citrate as an adjunct to other colonic preparations may also be helpful in patients who have previously had inadequate preparation by using a standard bowel preparation or those with a long-standing history of constipation.
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2014, GastroenterologyCitation Excerpt :Several 4-L PEG-ELS–based preparations have been approved by the FDA, including Colyte (Alaven Pharmaceuticals, Marietta, GA), Gavilyte (Gavis Pharmaceuticals, Somerset, NJ), Golytely (Braintree Laboratories), and Nulytely (Braintree Laboratories), which is sulfate free. High-volume PEG-ELS (≥3 L) was compared with low-volume PEG-ELS (<3 L) in 28 trials yielding 7208 intention-to-treat (ITT) patients (3456 high-volume PEG-ELS; 3752 low-volume PEG-ELS).18,63–89 Twenty-one trials included analyzable bowel-cleanliness outcomes.64–72,74–76,79,81–86,88,89
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2024, Current Opinion in GastroenterologyOral sulfate solution versus polyethylene glycol for colonoscopy bowel preparation: a randomized controlled study in phase Ⅲ
2022, Chinese Journal of Digestive Endoscopy
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From the Division of Digestive Diseases and Nutrition, Dorn Veterans' Affairs Medical Center, University of South Carolina at Columbia.
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Reprint requests: V. K. Sharma, MD, Division of Digestive Diseases and Nutrition, 2 Medical Park, Suite 507A, Columbia, SC 29203-6808.
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