Prospective, randomized study comparing two different regimens of split-dose polyethylene glycol and their effect on endoscopic outcomes
Abstract Background Different split regimens of polyethylene glycol are routinely used and no guidelines are available to select an optimal protocol of ingestion. This study aims to compare the efficacy and side effect profile of two different regimens of polyethylene glycol bowel preparation soluti...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-024-03212-z |
| _version_ | 1797209310049075200 |
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| author | Jawad Abou Zeid Souheil Hallit Bassem Akiki Zeina Abou Zeid Charbel Yazbeck |
| author_facet | Jawad Abou Zeid Souheil Hallit Bassem Akiki Zeina Abou Zeid Charbel Yazbeck |
| author_sort | Jawad Abou Zeid |
| collection | DOAJ |
| description | Abstract Background Different split regimens of polyethylene glycol are routinely used and no guidelines are available to select an optimal protocol of ingestion. This study aims to compare the efficacy and side effect profile of two different regimens of polyethylene glycol bowel preparation solution: PEG (3 + 1) vs. PEG (2 + 2). Methods 240 patients above the age of 18 years were included in the study between June 1st and November 31st, 2023. Patients were randomly assigned either to Group A, consisting of 115 patients receiving a 3 L of PEG the night before the colonoscopy, and 1 L the same morning of the procedure. Or to group B, where 125 patients ingested 2 L the night before the procedure, and the remaining 2 L the same morning. The cleansing efficacy was evaluated by the attending endoscopist using the Boston Bowel Preparation Scale, through a score assigned for each segment of the colon (0–3). Side effects, tolerability, and willingness to retake the same preparation were listed by an independent investigator using a questionnaire administered before the procedure. Results A higher percentage of patients had gastric fullness with the 3 + 1 vs. 2 + 2 preparation (58.3% vs. 31.2%; p <.001). A higher Boston bowel preparation score was seen in patients who took the 2 + 2 vs. 3 + 1 preparation (7.87 vs. 7.23). Using the 2 + 2 preparation was significantly associated with higher Boston bowel preparation scores vs. the 3 + 1 preparation (OR = 1.37, p =.001, 95% CI 1.14, 1.64). After adjustment over other variables (age, gender, comorbidities, previous abdominal surgeries, presence of adenoma, and time between last dose and colonoscopy), results remained the same (aOR = 1.34, p =.003, 95% CI 1.10, 1.62). Conclusion While both (2 + 2) and (3 + 1) regimens of polyethylene glycol are a good choice for a successful colonoscopy, we recommend the use of (2 + 2) regimen for its superior efficacy in bowel cleansing. |
| first_indexed | 2024-04-24T09:52:40Z |
| format | Article |
| id | doaj.art-e3717c6317524fe789611e50e38d7db0 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-24T09:52:40Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-e3717c6317524fe789611e50e38d7db02024-04-14T11:18:06ZengBMCBMC Gastroenterology1471-230X2024-04-012411710.1186/s12876-024-03212-zProspective, randomized study comparing two different regimens of split-dose polyethylene glycol and their effect on endoscopic outcomesJawad Abou Zeid0Souheil Hallit1Bassem Akiki2Zeina Abou Zeid3Charbel Yazbeck4School of Medicine and Medical Sciences, Holy Spirit University of KaslikSchool of Medicine and Medical Sciences, Holy Spirit University of KaslikSchool of Medicine and Medical Sciences, Holy Spirit University of KaslikSchool of Medicine and Medical Sciences, Holy Spirit University of KaslikSchool of Medicine and Medical Sciences, Holy Spirit University of KaslikAbstract Background Different split regimens of polyethylene glycol are routinely used and no guidelines are available to select an optimal protocol of ingestion. This study aims to compare the efficacy and side effect profile of two different regimens of polyethylene glycol bowel preparation solution: PEG (3 + 1) vs. PEG (2 + 2). Methods 240 patients above the age of 18 years were included in the study between June 1st and November 31st, 2023. Patients were randomly assigned either to Group A, consisting of 115 patients receiving a 3 L of PEG the night before the colonoscopy, and 1 L the same morning of the procedure. Or to group B, where 125 patients ingested 2 L the night before the procedure, and the remaining 2 L the same morning. The cleansing efficacy was evaluated by the attending endoscopist using the Boston Bowel Preparation Scale, through a score assigned for each segment of the colon (0–3). Side effects, tolerability, and willingness to retake the same preparation were listed by an independent investigator using a questionnaire administered before the procedure. Results A higher percentage of patients had gastric fullness with the 3 + 1 vs. 2 + 2 preparation (58.3% vs. 31.2%; p <.001). A higher Boston bowel preparation score was seen in patients who took the 2 + 2 vs. 3 + 1 preparation (7.87 vs. 7.23). Using the 2 + 2 preparation was significantly associated with higher Boston bowel preparation scores vs. the 3 + 1 preparation (OR = 1.37, p =.001, 95% CI 1.14, 1.64). After adjustment over other variables (age, gender, comorbidities, previous abdominal surgeries, presence of adenoma, and time between last dose and colonoscopy), results remained the same (aOR = 1.34, p =.003, 95% CI 1.10, 1.62). Conclusion While both (2 + 2) and (3 + 1) regimens of polyethylene glycol are a good choice for a successful colonoscopy, we recommend the use of (2 + 2) regimen for its superior efficacy in bowel cleansing.https://doi.org/10.1186/s12876-024-03212-zPolyethylene glycolSplit doseGastric fullnessColon cancerAdequate bowel preparationBoston bowel preparation score |
| spellingShingle | Jawad Abou Zeid Souheil Hallit Bassem Akiki Zeina Abou Zeid Charbel Yazbeck Prospective, randomized study comparing two different regimens of split-dose polyethylene glycol and their effect on endoscopic outcomes BMC Gastroenterology Polyethylene glycol Split dose Gastric fullness Colon cancer Adequate bowel preparation Boston bowel preparation score |
| title | Prospective, randomized study comparing two different regimens of split-dose polyethylene glycol and their effect on endoscopic outcomes |
| title_full | Prospective, randomized study comparing two different regimens of split-dose polyethylene glycol and their effect on endoscopic outcomes |
| title_fullStr | Prospective, randomized study comparing two different regimens of split-dose polyethylene glycol and their effect on endoscopic outcomes |
| title_full_unstemmed | Prospective, randomized study comparing two different regimens of split-dose polyethylene glycol and their effect on endoscopic outcomes |
| title_short | Prospective, randomized study comparing two different regimens of split-dose polyethylene glycol and their effect on endoscopic outcomes |
| title_sort | prospective randomized study comparing two different regimens of split dose polyethylene glycol and their effect on endoscopic outcomes |
| topic | Polyethylene glycol Split dose Gastric fullness Colon cancer Adequate bowel preparation Boston bowel preparation score |
| url | https://doi.org/10.1186/s12876-024-03212-z |
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