Document Detail


Randomized trial of low-volume PEG solution versus standard PEG + electrolytes for bowel cleansing before colonoscopy.
MedLine Citation:
PMID:  18190651     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Polyethylene glycol (PEG)-based gut lavage solutions are safe and effective, but require consumption of large volumes of fluid. We compared a new 2 L solution of PEG plus ascorbic acid (PEG + Asc) with standard 4 L PEG with electrolytes (PEG + E) for bowel cleansing before colonoscopy to determine efficacy, safety, and patient acceptability. METHODS: Consenting adult inpatients scheduled to undergo colonoscopy were randomized to receive either 2 L PEG + Asc or 4 L PEG + E. Preparations were taken as split doses the evening before colonoscopy and the following morning. The PEG + Asc group took 1 L at each administration (i.e., total dose of 2 L). The PEG + E group took 2 L at each administration (i.e., total dose of 4 L). Bowel cleansing success was assessed via videotapes by independent, blinded raters. Statistical noninferiority was predefined as a difference of <15% in the lower limit of the 97.5% confidence interval for treatment difference. Patient views on the preparations were elicited. Adverse events were noted. RESULTS: Successful gut cleansing was achieved in 136 of 153 (88.9%) cases of the PEG + Asc group and 147 of 155 (94.8%) cases of the 4 L PEG + E group (mean difference -5.9 [-12.0-infinity]). The difference fell within the predefined limit for noninferiority. Clinical and laboratory parameters showed no difference in safety profile. Patient ratings of acceptability and taste were better for the PEG + Asc group than for the PEG + E group (P < 0.025). CONCLUSIONS: The combination of ascorbic acid and PEG-based bowel preparation reduces the volume patients have to drink without compromising efficacy or safety. The low-volume PEG + Asc preparation was more acceptable to patients, and should, therefore, improve effectiveness in routine practice.
Authors:
Christian Ell; Wolfgang Fischbach; Hans-Joachim Bronisch; Stefan Dertinger; Peter Layer; Michael Rünzi; Thomas Schneider; Günther Kachel; Jörg Grüger; Michael Köllinger; Waltraud Nagell; Karl-Josel Goerg; Roland Wanitschke; Hans-Jürgen Gruss
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-01-11
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  103     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-09     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  883-93     Citation Subset:  IM    
Affiliation:
Dr. Horst Schmidt Kliniken GmbH, Wiesbaden, Germany.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00389233
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Ascorbic Acid / administration & dosage*
Cathartics / administration & dosage*
Colonoscopy*
Electrolytes / administration & dosage*
Female
Humans
Irrigation
Male
Middle Aged
Patient Compliance
Polyethylene Glycols / administration & dosage*
Solutions
Chemical
Reg. No./Substance:
0/Cathartics; 0/Electrolytes; 0/Polyethylene Glycols; 0/Solutions; 50-81-7/Ascorbic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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