Polyethylene Glycol-based Lavage Research Articles

Comparison of Mean Bowel Cleanliness Score in Patients Undergoing Colonoscopy Prepared by Sodium Phosphate versus Polyethylene

Background: Adequate bowel preparation is essential for accurate colonoscopy. Both oral sodium phosphate (NaP) and polyethylene glycol-based lavage (PEG-ELS) are used predominantly as bowel cleansing modalities. However, NaP has gained popularity due to low drinking volume and lower costs. Objective: To compare the mean bowel cleanliness score in patients undergoing colonoscopy prepared by sodium phosphate vs. polyethylene glycol. Study Design: It’s a randomized controlled trial Settings and Duration: Department of Gastroenterology Shaikh Zayed Hospital, Lahore, 6 months after the approval of synopsis, from Nov 2019 to April 2020. Methodology: After approval from ethical review committee of the hospital, 100 cases (50 in each group) patients who presented in Department of Gastroenterology Shaikh Zayed Hospital, Lahore and who fulfilled the criteria were counselled and explained the details of the study. Written informed consent and detailed history was taken from each patient. These patients were then randomly divided into following two groups using lottery method, Group-S: Sodium phosphate and Group-P: polyethyelene glycol. Cleanliness of the colon was noted as per operational definition. All the data was noted and recorded into the attached proforma along with demographic details of the patient. All the colonoscopies were done by the endoscopists with a same single observer recording the findings to eliminate bias, and confounding variables were controlled by exclusion. Results: In our study, of 100 cases (50 in each group) 48%(n=24) in Group-S and 52%(n=26) in Group-P were between 18-50 years of age whereas 52%(n=26) in Group-S and 48%(n=24) in Group-P were between 51-70 years of age, mean+sd was calculated as 51.64+8.82 years in S and 51.24+8.67 in P groups, 50%(n=25) in Group-S and 60%(n=30) in Group-P were male whereas 50%(n=25) in Group-S and 40%(n=20) in Group-P were females. Comparison of mean bowel cleanliness score in patients undergoing colonoscopy prepared by sodium phosphate vs. polyethylene glycol shows that Group-S had 3.82+0.92 and Group-P had 2.68+0.68 cleanliness score, p value was 0.0001. The results of our study are comparable with the above study. Conclusion: We concluded that the mean bowel cleanliness score was significantly better in patients undergoing colonoscopy prepared with sodium phosphate when compared with polyethylene glycol. Keywords: Colonoscopy, Sodium phosphate, Polyethylene glycol, Bowel cleanliness

Tu1368 A Randomized Prospective Trial Comparing Different Regimens of Polyethylene Glycol-Based Lavage and Sodium Picosulphate With Magnesium Citrate in the Preparation of Patients for Colonoscopy

Adequate bowel cleansing is essential for a high-quality, effective, and safe colonoscopy. There are rare reports that compare directly conventional polyethylene glycol (PEG) solultion and sodium picosulphate with magnesium citrate (SPMC) for bowel preparation. The aim of this study is to compare the efficacy, safety, and tolerability of different regimens of SPMC and PEG solution.Mehods: A total of 200 outpatients undergoing elective colonoscopy were randomized into four groups with endoscopist was blinded to the regimen.

A Randomized Prospective Trial Comparing Polyethylene Glycol-Based Lavage and Split Dose Polyethylene Glycol-Based Lavage in the Preparation of Patients Undergoing Colonoscopy

A Randomized Prospective Trial Comparing Polyethylene Glycol-Based Lavage and Split Dose Polyethylene Glycol-Based Lavage in the Preparation of Patients Undergoing Colonoscopy

Predictors of Poor Bowel Preparation in Colonoscopy

Purpose: A poorly prepared colon can lead to missed lesions and repeated procedures that increase cost and complication risk. The aim of the study was to identify predictive factors of poor colon prep, including obesity, which increases risk of neoplasia. Methods: Retrospective review of 1815 reports of inpatient (IP) and outpatient (OP) colonoscopies performed from June to October 2007 at a tertiary referral center. Prior colectomy, repeat colonoscopy, incomplete reports were excluded and 1588 reports analyzed. The endoscopist's inability to adequately evaluate the entire colonic mucosa and request for earlier than expected repeat colonoscopy (ACG, ASGE guidelines) were used to determine a poor or inadequate prep (PIP). Results: Good to excellent prep quality was reported in 400 (25.2%) patients and PIP in 627 (39.5%) patients. Patients with PIP were older (59.57 ± 13.5 yrs) and had higher weight (86.19 ± 23.9 kg) and BMI (29.74 ± 7.84 kg/m2) (P < .01). In univariate analysis, male gender, inpatient status (IP), Polyethylene glycol based lavage (PEG), smoking, lack of regular alcohol consumption, diabetes mellitus (DM), hypertension, coronary artery disease (CAD) increased BMI, depression, mental retardation (MR) and use of anti-depressant medications or narcotics were predictive of PIP. However, in multivariate logistic regression analysis, only male gender (OR = 0.75, P= 0.02), IP status (OR = 1.92, P= 0.002), smoking (OR = 1.62, P= 0.003), lack of regular alcohol consumption (OR = 0.68, P= 0.0003), DM (OR = 1.64, P= 0.0006), MR (OR = 3.54, P= 0.0004), narcotic use (OR = 3.04, P < 0.0001), and PEG (OR = 0.53, P= 0.0004) were predictors of poor bowel preparation. Modeling for composite outcome using univariate analysis: older age, male gender, IP status, smoking, lack of regular alcohol consumption, DM, hypertension, CAD, increased BMI, depression, obstructive sleep apnea, MR and consumption of anti-depressant medications or narcotics were predictive of PIP. However, in multivariate logistic regression analysis, only older age (OR = 1.009, P= 0.01), male gender (OR = 0.71, P= 0.002), IP status (OR = 1.55, P= 0.008), smoking (OR = 1.35, P= 0.01), lack of regular alcohol consumption (OR = 0.7, P= 0.01), increased BMI (OR = 1.02, P= 0.004), MR (OR = 2.17, P= 0.03), use of antidepressant medication (OR = 1.69, P= 0.001), and narcotic use (OR = 2.1, P= 0.001) were predictors of PIP. Conclusion: Poorly prepped colons reduce diagnostic yield. Aborted and repeat procedures greatly increase the cost of colonoscopy. Prior identification and aggressive bowel cleansing of patients with predictive factors of PIP can lead to improved diagnostic yield and cost savings. This needs to be verified in a prospective study.

Bowel Preparation for Colonoscopy with Sodium Phosphate Solution versus Polyethylene Glycol-Based Lavage: A Multicenter Trial

Background: Adequate bowel preparation is essential for accurate colonoscopy. Both oral sodium phosphate (NaP) and polyethylene glycol-based lavage (PEG-ELS) are used predominantly as bowel cleansing modalities. NaP has gained popularity due to low drinking volume and lower costs. The purpose of this randomized multicenter observer blinded study was to compare three groups of cleansing (NaP, NaP + sennosides, PEG-ELS + sennosides) in reference to tolerability, acceptance, and cleanliness. Patient and Methods: 355 outpatients between 18 and 75 years were randomized into three groups (A, B, C) receiving NaP = A, NaP, and sennosides = B or PEG-ELS and sennosides = C. Gastroenterologists performing colonoscopies were blinded to the type of preparation. All patients documented tolerance and adverse events. Vital signs, premedication, completeness, discomfort, and complications were recorded. A quality score (0–4) of cleanliness was generated. Results: The three groups were similar with regard to age, sex, BMI, indication for colonoscopy, and comorbidity. Drinking volumes (L) (A = 4.33 + 1.2, B = 4.56 + 1.18, C = 4.93 + 1.71) were in favor of NaP (P = .005). Discomfort from ingested fluid was recorded in A = 39.8% (versus C: P = .015), B = 46.6% (versus C: P = .147), and C = 54.6%. Differences in tolerability and acceptance between the three groups were statistically not significant. No differences in adverse events and the cleanliness effects occurred in the three groups (P = .113). The cleanliness quality scores 0–2 were calculated in A: 77.7%, B: 86.7%, and C: 85.2%. Conclusions: These data fail to demonstrate significant differences in tolerability, acceptance, and preparation quality between the three types of bowel preparation for colonoscopy. Cleansing with NaP was not superior to PEG-ELS.