Efficacy of Prokinetics with a Split-Dose of Polyethylene Glycol in Bowel Preparation for Morning Colonoscopy: A Randomized Controlled Trial

• Published in: Digestion Vol. 86; no. 3; pp. 194 - 200
• Main Authors: Kim, Hyoung Jun, Kim, Tae Oh, Shin, Bong Chul, Woo, Jae Gon, Seo, Eun Hee, Joo, Hee Rin, Heo, Nae-Yun, Park, Jongha, Park, Seung Ha, Yang, Sung Yeon, Moon, Young Soo, Shin, Jin-Yong, Lee, Nae Young
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2012
• Subjects: Benzamides - administration & dosage; Benzyl Compounds - administration & dosage; Colon - drug effects; Colonoscopy - methods; Colorectal Neoplasms - diagnosis; Dose-Response Relationship, Drug; Drug Combinations; Female; Humans; Male; Middle Aged; Original Paper; Patient Compliance; Polyethylene Glycols - administration & dosage; Prospective Studies; Reproducibility of Results; Single-Blind Method; Surface-Active Agents - administration & dosage; Bowel preparation; Prokinetics; Colonoscopy
• ISSN: 0012-2823; 1421-9867
• DOI: 10.1159/000339780

Background/Aims: Currently, a split-dose of polyethylene glycol (PEG) is the mainstay of bowel preparation due to its tolerability, bowel-cleansing action, and safety. However, bowel preparation with PEG is suboptimal because residual fluid reduces the polyp detection rate and requires a more thorough colon inspection. The aim of our study was to demonstrate the efficacy of a sufficient dose of prokinetics on bowel cleansing together with split-dose PEG. Methods: A prospective endoscopist-blinded study was conducted. Patients were randomly allocated to two groups: prokinetic with split-dose PEG or split-dose PEG alone. A prokinetic [100 mg itopride (Itomed®)], was administered twice simultaneously with each split-dose of PEG. Bowel-cleansing efficacy was measured by endoscopists using the Ottawa scale and the segmental fluidity scale score. Each participant completed a bowel preparation survey. Mean scores from the Ottawa scale, segmental fluid scale, and rate of poor preparation were compared between both groups. Results: Patients in the prokinetics with split-dose PEG group showed significantly lower total Ottawa and segmental fluid scores compared with patients in the split-dose of PEG alone group. Conclusion: A sufficient dose of prokinetics with a split-dose of PEG showed efficacy in bowel cleansing for morning colonoscopy, largely due to the reduction in colonic fluid.