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Gastroenterol Hepatol. 2015 Feb;38(2):62-70. doi: 10.1016/j.gastrohep.2014.09.007. Epub 2014 Oct 29.

Ascorbic acid PEG-2L is superior for early morning colonoscopies in colorectal cancer screening programs: a prospective non-randomized controlled trial.

Author information

1
Department of Gastroenterology, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
2
Preventive Medicine and Hospital Epidemiology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.
3
Department of Anesthesiology, Hospital Clínic, Barcelona, Spain.
4
Department of Gastroenterology, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Electronic address: mpellise@clinic.cat.

Abstract

BACKGROUND:

The quality of colon cleansing and the tolerability of anterograde preparation are essential to the success of colorectal cancer screening.

AIM:

To compare the tolerability and efficacy of low-volume preparations vs the standard regimen in individuals scheduled for an early morning colonoscopy.

STUDY:

Participants in a population-based colorectal cancer screening program using the fecal immunochemical test who were scheduled for a colonoscopy from 09:00 a.m. to 10:20 a.m. were prospectively included and assigned to: (1) control group (PEG-ELS 4L): PEG 4L and electrolytes; (2) group AscPEG-2L: a combination of PEG and ascorbic acid 2L; and (3) group PiMg: sodium picosulfate and magnesium citrate 500 mL plus 2L of clear fluids. Tolerability was evaluated with a questionnaire and the quality of bowel preparation with the Boston Bowel Preparation Scale.

RESULTS:

A total of 292 participants were included: 98 in the PEG-ELS 4L control group, 96 in the AscPEG-2L study group and 98 in the PiMg study group. Low-volume treatments were better tolerated than the standard solution (AscPEG-2L 94.8% and PiMg 93.9% vs PEG-ELS 4L 75.5%; p < 0.0001). The effectiveness of AscPEG-2L was superior to that of PEG-ELS 4L and PiMg (p = 0.011 and p = 0.032, respectively). Patient acceptance was higher for single-dose than for split-dose administration but efficacy was higher with the split dose than with other doses.

CONCLUSIONS:

In early morning colonoscopies, ascPEG-2L appears to be the best option, especially when administered in a split-dose.

KEYWORDS:

Bowel cleansing; Clinical trial; Colonoscopia; Colonoscopia de calidad; Colonoscopy; Colorectal cancer screening; Cribado de cáncer colorectal; Ensayo clínico; Preparación anterógrada; Preparation; Quality endoscopy

PMID:
25458542
DOI:
10.1016/j.gastrohep.2014.09.007
[Indexed for MEDLINE]

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