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Study shows splitting bowel preparation dosage is most effective cleansing method before colonoscopy
Date:8/5/2010

n-split-dosage of two different volumes of PEG solution, low-volume PEG plus ascorbic acid versus standard-volume PEG, and to identify predictors of poor bowel cleansing," said study lead author Riccardo Marmo, MD, Hospital "L. Curto," Polla, Sant' Arsenio, Italy. "We demonstrated that a split-dosage regimen provides the best colon cleansing independent of the volume of PEG and that the optimal timing of colonoscopy is within eight hours of the last fluid intake. The study also found that male patients were at higher risk of poor bowel cleansing and that procedures might be better scheduled late-morning or in the afternoon to allow for split dosing, especially for male patients."

Patients and Methods

This was a single-blind, active control, prospective, randomized study of adult (18 years of age or over) patients undergoing routine elective colonoscopy. A total of 868 randomized patients were analyzed: 435 patients in the spilt-dosage group and 433 in the non-split-dosage group. Two cleansing products were used in the study: PEG 4000 plus electrolytes (standard PEG solution) taken diluted into four liters of plain water (high-volume) and the low-volume solution composed of macrogol 3350 plus electrolytes and 4.700 grams ascorbic acid taken diluted into two liters of plain water. Patients were randomly allocated to receive one of the four different bowel preparation regimens (split-dosage vs. non-split-dosage, low- vs. high-volume). The preparations were dispensed by a nurse endoscopist who carefully explained how they should be taken, emphasizing the importance of complete intake of the solution to ensure a safe and effective procedure. Dietary advice was also given to patients and all patients were instructed to take nothing by mouth from midnight on before the procedure.

Bowel cleansing was assessed by colonoscopists who were unaware of the preparation method. For each anatomical segment of the colon, the degree of bowel cleansing was
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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