Efficacy, Safety, and Tolerance of Split Dose Oral Sulfate Solution Versus Split-Dose Polyethylene Glycol Versus Single Dose Polyethylene Glycol for Colonoscopy Preparation: A Prospective Randomized Study.

BACKGROUND

The quality of bowel preparation is one of the key determinants of a successful colonoscopy. Bowel preparation regimens have evolved greatly over the past few decades, with attempts to improve the efficiency and tolerability; still an ideal agent or regimen continues to be oblivious. To compare the efficacy, safety, and tolerance of three bowel preparation regimens for colonoscopy: split dose of oral sulfate solution (OSS), split dose of polyethylene glycol (PEG), and same-day single dose PEG.

METHODS

This study was a randomized, single-blind control design with three study groups. Group A received a split dose of OSS, group B received a split dose of PEG, and Group C received a single dose of PEG for bowel preparation. The quality of preparation was assessed using the Boston Bowel Preparation Scale (BBPS), and the adverse effects and tolerance were noted. The data were compared statistically for any significant difference between the regimens.

RESULTS

Mean total BBPS scores were 8.08, 7.52, and 7.92 for groups A, B, and C, respectively (=0.076). Segmental BBPS scores were statistically similar for the right and transverse colon but differed for the left colon (A: B: C=2.79: 2.54: 2.75; <0.01). Gastrointestinal side effects and electrolyte disturbances were similar across the three groups. Split-dose preparations were associated with more significant sleep disturbances than single-dose PEG (<0.001). Patients who received OSS reported more taste intolerance (<0.01), while those who received single PEG reported more volume intolerance (<0.001).

CONCLUSION

Split-dose OSS, split-dose PEG, and single-dose PEG regimens provide adequate and comparable bowel preparation for colonoscopy with good patient tolerance and no significant adverse effects. Overnight PEG and OSS preparations were associated with more substantial sleep disturbances. OSS is associated with more taste intolerance, while single PEG is associated with more volume intolerance.