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Randomized Controlled Trial: Split-dose and Same-day Large Volume Bowel Preparation for Afternoon Colonoscopy Have Similar Quality of Preparation.

Abstract：

GOALS:We compare bowel cleanliness in patients taking same-day versus split-dose 4-L polyethylene glycol laxative for afternoon colonoscopy. Secondary objectives included patient satisfaction, adverse effects and patient tolerability. BACKGROUND:Afternoon colonoscopies have been associated with inadequate bowel preparation and lower adenoma detection rates. Same-day (morning) or split-dosing of the laxative have improved preparation quality but differences between these options are unclear. MATERIALS AND METHODS:Single-center prospective randomized endoscopist blinded trial. Patients aged 18 years and above prescribed 4-L polyethylene glycol for colonoscopy were randomized into same-day or split-dose preparation. Preparation quality was assessed using the Ottawa Bowel Preparation Scale. Patient satisfaction and side effects was collected using a questionnaire. Intention-to-treat and per-protocol analysis were performed. RESULTS:A total of 300 patients (158 split-dose, 142 same-day) were evaluated. No statistically significant difference was seen on total Ottawa score among the groups (P=0.47) or by individual colonic segments in intent-to-treat and per-protocol analysis. Patients in split-dose group were more likely to complete the entire preparation (P=0.01) but reported more sleep loss (P=0.001). The same-day preparation group reported higher incidence of vomiting (P=0.036). Patients ingesting bowel preparation ≥7 hours before colonoscopy had higher total Ottawa scores (P=0.001). CONCLUSIONS:There were no differences in quality of preparation in patients taking same-day versus split-dose preparation for afternoon colonoscopy. Those receiving same-day preparation were less likely to lose sleep but more likely to have emesis. These differences should be considered when selecting a bowel preparation regimen.

journal_name

J Clin Gastroenterol

journal_title

Journal of clinical gastroenterology

authors

Castro FJ,Al-Khairi B,Singh H,Mohameden M,Tandon K,Lopez R

doi

10.1097/MCG.0000000000001213

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

724-730

issue

eissn

0192-0790

issn

1539-2031

journal_volume

pub_type

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Randomized Controlled Trial: Split-dose and Same-day Large Volume Bowel Preparation for Afternoon Colonoscopy Have Similar Quality of Preparation.