Low-Volume Polyethylene Glycol with Ascorbic Acid for Colonoscopy Preparation in Elderly Patients: A Randomized Multicenter Study

Abstract

Background: Minimal data exist regarding the use of low-volume purgatives for elderly (≥65 years) patients. We aimed to investigate the bowel-cleansing efficacy and patient tolerability of split-dose 2 liters (L)-polyethylene glycol with ascorbic acid (2L-PEGA) in elderly outpatients undergoing colonoscopy. Methods: Patients who underwent morning colonoscopies were randomly assigned to one of 3 arms: single-dose 4L-PEG on the day before colonoscopy; split-dose 4L-PEG; or split-dose 2L-PEGA. The quality of bowel preparation was assessed using the Boston Bowel Preparation Scale (BBPS). Results: Of 230 patients enrolled, 198 were analyzed. The proportion of adequate bowel preparations in split-dose 2L-PEGA was higher than that in single-dose 4L-PEG (92.1 vs. 75.0%, p = 0.009) and similar to split-dose 4L-PEG. The mean BBPS scores for global and right colon preparation in the split-dose 2L-PEGA were comparable to split-dose 4L-PEG but higher than those in the single-dose 4L-PEG. The proportion of patients who ingested the entire volume of solution in 2L-PEGA was higher than that in single-dose 4L-PEG (96.8 vs. 80.9%, p = 0.011). Patients receiving 2L-PEGA expressed more willingness to repeat the same preparation than other groups. The rate of adverse events did not differ among the 3 groups. Conclusions: Split-dose 2L-PEGA was an effective, safe, and comfortable method for colonoscopy preparation in elderly outpatients.