A Prospective Trial Comparing 4 L-Polyethylene Glycol with 2 L-Polyethylene Glycol Plus Bisacodyl Tablets for Colon Preparation

Kang, Min Jung; Jung, Sung Ae; Jung, Ji Min; Song, Hyun Joo; Kim, Seong Eun; Jung, Hye Kyung; Shim, Ki Nam; Yoo, Kwon; Moon, Il Hwan

Abstract

BACKGROUND/AIMS
The aim of the study was to prospectively compare low-volume PEG plus 20 mg bisacodyl with the standard 4 L PEG with regards to the adequacy of bowel preparation, patient compliance and the side effects. METHODS: From September 2007 to January 2008, 59 patients who had previously undergone screening colonoscopy with 4 L PEG and had been diagnosed with colonic polyps were admitted for polypectomy. The colonoscopists, who were unaware of the preparation that was administered, evaluated the adequacy of the bowel cleansing. Detailed questionnaires were also used to assess patient compliance, the difficulty of bowel preparation, side effects and patient preference. RESULTS: The physician's evaluation of the colon cleansing showed better adequacy with 4 L PEG than with 2 L PEG plus bisacodyl (p<0.05). There was no difference in patient compliance between the 2 bowel preps. The patients in the 2 L PEG plus bisacodyl group tolerated the bowel preparation more easily than the patients in the 4 L PEG (81.4% vs. 15.3%, respectively). Moreover, the scores of the visual analog scale for the difficulty of bowel preparation were 5.8+/-2.3 in the 4 L PEG group and 3.2+/-1.9 in the 2 L PEG plus bisacodyl (p<0.01). The majority (89.8%) of the patients preferred 2 L PEG plus bisacodyl (p<0.001). The 2 L PEG plus bisacodyl group revealed less nausea, vomiting and sleep discomfort (p<0.05), but they had more abdominal pain (p<0.01). CONCLUSIONS: 2 L PEG plus bisacodyl is not as effective as the standard 4 L PEG for colon cleansing. However, 2 L PEG plus bisacodyl can be used for patients who have difficulty drinking a large amount of PEG.