Combined low-volume polyethylene glycol solution plus stimulant laxatives versus standard-volume polyethylene glycol solution: A prospective, randomized study of colon cleansing before colonoscopy

INTRODUCTION: The effectiveness of polyethylene glycol solutions (PEG) for colon cleansing is often limited by the inability of patients to drink adequate portions of the 4 L Solution. The aim of the present study was to determine whether a reduced volume of PEG combined With stimulant laxatives would be better tolerated and as or more effective than the standard dose. METHODS: Patients Undergoing outpatient colonoscopy were randomly assigned to receive either low-volume PEG plus sennosides (120 mg Oral sennosides syrup followed by 2 L PEG) or the standard volume preparation (4 L PEG). The subjects rated the tolerability of the preparations and their symptoms. Colonoscopists were blind to the colonic cleansing preparation and graded the cleansing efficacy using a validated tool (the Ottawa scale). RESULTS: The low-volume PEG plus sennosides preparation was significantly better tolerated than the standard large volume PEG ( P < 0.001) but Was less efficacious (P=0.03). Thirty-eight per cent of patients in the large volume PEG group were unable to finish the preparation, compared with only 6% in the reduced volume group. There were no adverse events reported. CONCLUSIONS: Although the low-volume! PEG plus sennosides preparation was better tolerated, it was not as effective as standard large-volume PEG. However, in view Of the significant difference in tolerance, further research investigating possible improvements in the reduced-volume regimen seems warranted.