TWO LITERS OF POLYETHYLENE GLYCOL (PEG) WITH 15 MG OF BISACODYL VERSUS 4 LITERS OF PEG FOR BOWEL PREPARATION TO COLONOSCOPY

Aims:

Comparing the tolerance, acceptability and efficacy of a protocol A based on 4L of PEG and a protocol B corresponding to 2L of PEG + 15 mg of Bisacodyl.

Methods:

A prospective comparative randomized study. Using the Boston Bowel Préparation Scale (BBPS) by endoscopists, who did not know bowel preparation type, to evaluate the quality of preparation.

Results:

123 patients were included (62 in group A and 61 in group B), with a sex ratio = 1. The average age of patients was 52 years [17 – 86 years]. The frequency of nausea and bloating were respectively (26% and 18% vs. 12% and 7%). A statistically significant decrease in nausea and bloating rates was observed in group B compared to group A (p = 0.035 and p = 0.05). Moreover, 7 patients in group A had sleep disorders vs. 3 cases in group B. 6 patients who received 4L of PEG has expressed their refusal to resume the same preparation if necessary while 2 patients in group B had refused.

In terms of efficiency; A Boston score greater than or equal to 7 was recorded in 68% versus 75% of patient respectively (p = NS). On average, the overall score obtained was 6.77 versus 6.95 respectively. This score did not show a statistically significant difference in efficacy between the 2 groups in different colic segments; in the right segment, the score was noted: 2.40 vs. 2.31, transverse colon: 2.46 vs. 2.52 and left colon: 2.12 vs. 2. However, the maximum score (9/9) was observed in 7 patients in group B vs. 4 patients in group A.

Conclusions:

Our study showed that the low-volume 2 L PEG with 15 mg bisacodyl improves patient tolerability as compared to the traditional 4 L PEG with de same efficacy of bowel preparation between the two protocols.