AIM: To compare same-day whole-dose vs split-dose of 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for colon cleansing for morning colonoscopy.
To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODS...To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODSFrom February 2015 to March 2015, examinees of average risk who were scheduled for a colonoscopy in the morning were retrospectively enrolled.RESULTSThe 189 examinees were divided into split-dose and non-split-dose groups. The adequacy of bowel preparation for the split-dose group vs the non-split-dose group was 96.8% vs 85.2%, respectively, P < 0.001, and the compliance of the last meal restriction was 74.6% vs 58.2%, respectively, P < 0.001. The sleep disturbance (P < 0.001) was more prevalent in the split-dose group, however the willingness to repeat the same preparation method (P = 0.243) was not different in both groups. The split-dose regimen was the most important factor influencing adequate bowel preparation in multivariate analysis (HR = 10.89, 95%CI: 6.53-18.17, P < 0.001).CONCLUSIONA split-dose regimen of 2 L PEG/AA for an early morning colonoscopy was more effective and showed better compliance for diet restriction without any difference in satisfaction and discomfort. Introducing a split-dose regimen of 2 L PEG/AA to morning colonoscopy examinees is effective and tolerable in a comprehensive medical check-up setting.展开更多
BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep dis...BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep disturbance associated with night doses.Meanwhile,the same-day single-dose regimens(SSDs)of PEG has been recommended as an alternative;however,its superiority compared to other regimens is a matter of debate.AIM To compare the efficacy and tolerability between SSDs and large-volume SpDs PEG for bowel preparation.METHODS We searched MEDLINE/PubMed,the Cochrane Library,RCA,EMBASE and Science Citation Index Expanded for randomized trials comparing(2 L/4 L)SSDs to large-volume(4 L/3 L)SpDs PEG-based regimens,regardless of adjuvant laxative use.The pooled analysis of relative risk ratio and mean difference was calculated for bowel cleanliness,sleep disturbance,willingness to repeat the procedure using the same preparation and adverse effects.A random effects model or fixed-effects model was chosen based on heterogeneity analysis among studies.RESULTS A total of 18 studies were included.There was no statistically significant difference of adequate bowel preparation(relative risk=0.97;95%CI:0.92-1.02)(14 trials),right colon Boston Bowel Preparation Scale(mean difference=0.00;95%CI:-0.04,0.03)(9 trials)and right colon Ottawa Bowel Preparation Scale(mean difference=0.04;95%CI:-0.27,0.34)(5 trials)between(2 L/4 L)SSDs and large-volume(4 L/3 L)SpDs,regardless of adjuvant laxative use.The pooled analysis favored the use of SSDs with less sleep disturbance(relative risk=0.52;95%CI:0.40,0.68)and lower incidence of abdominal pain(relative risk=0.75;95%CI:0.62,0.90).During subgroup analysis,patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation than SpDs(P<0.05).No significant difference in adverse effects,including nausea,vomiting and bloating,was found between the two arms(P>0.05).CONCLUSION Regardless of adjuvant laxative use,the(2 L/4 L)SSD PEG-based arm was considered equal or better than the large-volume(≥3 L)SpDs PEG regimen in terms of bowel cleanliness and tolerability.Patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation due to the low-volume fluid requirement and less sleep disturbance.展开更多
BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results ...BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results have varied.AIM To examine the outcomes of SaD and SpD for afternoon colonoscopies.METHODS An extensive literature search was conducted using multiple databases.Only randomized controlled trials(RCTs)in adults that compared SaD to SpD with Ottawa bowel preparation score(OBPS)were included.Odds ratio(OR)or mean difference was used to analyze outcomes.RESULTS Eleven RCTs were included(n=1846).No difference was observed for satisfactory bowel preparation based on OBPS among participants receiving SaD vs SpD(OR 0.77;95%CI:-0.57-1.03;P=0.07;I2=5%).Subgroup analysis showed no difference in terms of satisfactory bowel preparation based on OBPS between the two groups when receiving same preparation formula(polyethylene glycol)(OR 0.83;95%CI:0.51-1.35;P=0.46;I2=39%)as well as receiving same formula and volume(4 L polyethylene glycol)(OR 1.14;95%CI:0.65-2.01;P=0.64;I2=0%).CONCLUSION In patients undergoing afternoon colonoscopies,SaD is comparable with SpD in terms of satisfactory bowel preparation.Further studies are needed to validate these results and determine the optimal formula and dosages.展开更多
AIM: To compare(using the Ottawa Bowel Preparation Scale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the ...AIM: To compare(using the Ottawa Bowel Preparation Scale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the optimal preparation-to-colonoscopy interval.METHODS: Single-centre, prospective, randomized, investigator-blind stud in an academic tertiarycare centre. Two hundred patients requiring elective colonoscopy were assigned to receive one of the two preparation regimens(split vs morning) prior to colonoscopy. Main outcome measurements were bowel preparation quality and patient tolerability.RESULTS: Split-dose regimen resulted in better bowel preparation compared to morning regimen [Ottawascore mean 5.52(SD 1.23) vs 6.02(1.34); P = 0.017]. On subgroup analysis, for afternoon procedures, both the preparations were equally effective(P = 0.756). There was no difference in tolerability and compliance between the two regimens.CONCLUSION: Overall, previous evening- same morning split-dosing regimen results in better bowel cleansing for colonoscopy compared to morning preparation. For afternoon procedures, both schedules are equally effective; morning preparation may be more convenient to the patient.展开更多
基金Supported by University of Malaya Research Grant,Project No.RG536-13HTM
文摘AIM: To compare same-day whole-dose vs split-dose of 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for colon cleansing for morning colonoscopy.
文摘To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODSFrom February 2015 to March 2015, examinees of average risk who were scheduled for a colonoscopy in the morning were retrospectively enrolled.RESULTSThe 189 examinees were divided into split-dose and non-split-dose groups. The adequacy of bowel preparation for the split-dose group vs the non-split-dose group was 96.8% vs 85.2%, respectively, P < 0.001, and the compliance of the last meal restriction was 74.6% vs 58.2%, respectively, P < 0.001. The sleep disturbance (P < 0.001) was more prevalent in the split-dose group, however the willingness to repeat the same preparation method (P = 0.243) was not different in both groups. The split-dose regimen was the most important factor influencing adequate bowel preparation in multivariate analysis (HR = 10.89, 95%CI: 6.53-18.17, P < 0.001).CONCLUSIONA split-dose regimen of 2 L PEG/AA for an early morning colonoscopy was more effective and showed better compliance for diet restriction without any difference in satisfaction and discomfort. Introducing a split-dose regimen of 2 L PEG/AA to morning colonoscopy examinees is effective and tolerable in a comprehensive medical check-up setting.
基金Supported by Startup Fund for scientific research,Fujian Medical University,No. 2019QH1181
文摘BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep disturbance associated with night doses.Meanwhile,the same-day single-dose regimens(SSDs)of PEG has been recommended as an alternative;however,its superiority compared to other regimens is a matter of debate.AIM To compare the efficacy and tolerability between SSDs and large-volume SpDs PEG for bowel preparation.METHODS We searched MEDLINE/PubMed,the Cochrane Library,RCA,EMBASE and Science Citation Index Expanded for randomized trials comparing(2 L/4 L)SSDs to large-volume(4 L/3 L)SpDs PEG-based regimens,regardless of adjuvant laxative use.The pooled analysis of relative risk ratio and mean difference was calculated for bowel cleanliness,sleep disturbance,willingness to repeat the procedure using the same preparation and adverse effects.A random effects model or fixed-effects model was chosen based on heterogeneity analysis among studies.RESULTS A total of 18 studies were included.There was no statistically significant difference of adequate bowel preparation(relative risk=0.97;95%CI:0.92-1.02)(14 trials),right colon Boston Bowel Preparation Scale(mean difference=0.00;95%CI:-0.04,0.03)(9 trials)and right colon Ottawa Bowel Preparation Scale(mean difference=0.04;95%CI:-0.27,0.34)(5 trials)between(2 L/4 L)SSDs and large-volume(4 L/3 L)SpDs,regardless of adjuvant laxative use.The pooled analysis favored the use of SSDs with less sleep disturbance(relative risk=0.52;95%CI:0.40,0.68)and lower incidence of abdominal pain(relative risk=0.75;95%CI:0.62,0.90).During subgroup analysis,patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation than SpDs(P<0.05).No significant difference in adverse effects,including nausea,vomiting and bloating,was found between the two arms(P>0.05).CONCLUSION Regardless of adjuvant laxative use,the(2 L/4 L)SSD PEG-based arm was considered equal or better than the large-volume(≥3 L)SpDs PEG regimen in terms of bowel cleanliness and tolerability.Patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation due to the low-volume fluid requirement and less sleep disturbance.
文摘BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results have varied.AIM To examine the outcomes of SaD and SpD for afternoon colonoscopies.METHODS An extensive literature search was conducted using multiple databases.Only randomized controlled trials(RCTs)in adults that compared SaD to SpD with Ottawa bowel preparation score(OBPS)were included.Odds ratio(OR)or mean difference was used to analyze outcomes.RESULTS Eleven RCTs were included(n=1846).No difference was observed for satisfactory bowel preparation based on OBPS among participants receiving SaD vs SpD(OR 0.77;95%CI:-0.57-1.03;P=0.07;I2=5%).Subgroup analysis showed no difference in terms of satisfactory bowel preparation based on OBPS between the two groups when receiving same preparation formula(polyethylene glycol)(OR 0.83;95%CI:0.51-1.35;P=0.46;I2=39%)as well as receiving same formula and volume(4 L polyethylene glycol)(OR 1.14;95%CI:0.65-2.01;P=0.64;I2=0%).CONCLUSION In patients undergoing afternoon colonoscopies,SaD is comparable with SpD in terms of satisfactory bowel preparation.Further studies are needed to validate these results and determine the optimal formula and dosages.
文摘AIM: To compare(using the Ottawa Bowel Preparation Scale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the optimal preparation-to-colonoscopy interval.METHODS: Single-centre, prospective, randomized, investigator-blind stud in an academic tertiarycare centre. Two hundred patients requiring elective colonoscopy were assigned to receive one of the two preparation regimens(split vs morning) prior to colonoscopy. Main outcome measurements were bowel preparation quality and patient tolerability.RESULTS: Split-dose regimen resulted in better bowel preparation compared to morning regimen [Ottawascore mean 5.52(SD 1.23) vs 6.02(1.34); P = 0.017]. On subgroup analysis, for afternoon procedures, both the preparations were equally effective(P = 0.756). There was no difference in tolerability and compliance between the two regimens.CONCLUSION: Overall, previous evening- same morning split-dosing regimen results in better bowel cleansing for colonoscopy compared to morning preparation. For afternoon procedures, both schedules are equally effective; morning preparation may be more convenient to the patient.
