Clinical value of split-dose polyethylene glycols combined with simethicone for morning colonoscopy preparation

Abstract

Objective To evaluate the performance of split-dosed polyethylene (PEG) combined with simethicone in bowel preparation for morning colonoscopy. Methods A total of 293 patients scheduled for morning colonoscopic examination were randomly assigned to receive either split-dosed 3 liter of PEG (2 L in the evening before examination and 1 L in the morning of examination)and 15 ml simethicone (Group A, n=147), or whole dose of 3 L PEG (the evening before examination) without simethicone (Group B, n=146). Bowel preparation quality, adenoma detection rate and patients′ acceptance were compared between groups. Results Group A had higher Boston Bowel Preparation Scale in overall colon (6.9 ± 3.1 VS 6.2 ± 2.8, P=0.032) and better preparation quality of right-side colon (2.6 ± 1.0 VS 2.0 ± 0.9, P=0.041). Adenoma detection rate was comparable between groups (31.3% VS 29.5%, P=0.796), but group A detected more small adenomas (≤1.0 cm) (64.5% VS 50.7%, P=0.043) and showed a improving trend for more right-side adenomas (32.3% VS 18.6%, P=0.075) than group B. More participants completed bowel preparation in group A than those in group B (98.6% VS 93.1%, P=0.020). Group A had fewer patients undergoing adverse events such as nausea and vomiting and fewer participants refusing to repeat colonoscopic examination (6.1% VS 13.7%, P=0.033) if necessary. Conclusion Split-dose PEG combined with simethicone can yield to better colon cleansing, detect more adenomas and ensure higher patient compliance. Key words: Adenomatous polyposis coli; Polyethylene glycols; Simethicone; Colonoscopy