2-Litre polyethylene glycol-citrate-simethicone plus bisacodyl versus 4-litre polyethylene glycol as preparation for colonoscopy in chronic constipation.

Abstract

BACKGROUND:

Chronic constipation is a risk factor of inadequate bowel preparation for colonoscopy; however, no large clinical trials have been performed in this subgroup of patients.

AIMS:

To compare bowel cleansing efficacy, tolerability and acceptability of 2-L polyethylene-glycol-citrate-simethicone (PEG-CS) plus 2-day bisacodyl (reinforced regimen) vs. 4-L PEG in patients with chronic constipation undergoing colonoscopy.

METHODS:

Randomized, observer-blind, parallel group study. Adult outpatients undergoing colonoscopy were randomly allocated to 2-L PEG-CS/bisacodyl or 4-L PEG, taken as split regimens before colonoscopy. Quality of bowel preparation was assessed by the Ottawa Bowel Cleansing Scale (OBCS). The amount of foam/bubble interfering with colonic visualization was also measured.

RESULTS:

400 patients were enrolled. There was no significant difference in successful cleansing (OBCS score ≤6): 80.2% in the 2-L PEG-CS/bisacodyl vs. 81.4% in the 4-L PEG group. Significantly more patients taking 2L PEG-CS/bisacodyl showed no or minimal foam/bubbles in all colonic segments (80% vs. 63%; p<0.001). 2-L PEG-CS/bisacodyl was significantly more acceptable for ease of administration (p<0.001), willingness to repeat (p<0.001) and showed better compliance (p=0.002).

CONCLUSION:

Split 2-L PEG-CS plus bisacodyl was not superior to split 4-L PEG for colonoscopy bowel cleansing in patients with chronic constipation; however, it performed better than the standard regimen in terms of colonic mucosa visualization, patient acceptance and compliance.

• Authors: Fabrizio Parente, Cristian Vailati, Stefano Bargiggia, Gianpiero Manes, Paola Fontana, Enzo Masci, Monica Arena, Giancarlo Spinzi, Alessandra Baccarin, Giorgia Mazzoleni, Pier Alberto Testoni
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 47 Issue 10 Pg. 857-63 (Oct 2015) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 26232311 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Cathartics
• Bisacodyl
• Citric Acid
• Polyethylene Glycols
• Simethicone

Topics

• Aged
• Bisacodyl (administration & dosage)
• Cathartics (administration & dosage, adverse effects)
• Chronic Disease
• Citric Acid (administration & dosage)
• Colon (drug effects)
• Colonoscopy (standards)
• Constipation (drug therapy)
• Female
• Humans
• Italy
• Male
• Middle Aged
• Patient Compliance
• Polyethylene Glycols (administration & dosage)
• Simethicone (administration & dosage)