EVALUATION OF THE COMBINED EFFECTS OF SPLIT VS. DAY BEFORE AND LOW RESIDUE VS. CLEAR FLUID REGIMENS ON THE COLONOSCOPY PREPARATION

Aims:

Colonoscopy is widely used to diagnose and treat colonic diseases. Its' accuracy and quality depends on the colonoscopy preparation. Split dosage of Polyethylene Glycol (PEG) has been shown to improve the colonoscopy preparation in comparison to the “day before” prescription. Also, using low residue diet can improve the patient's tolerance and satisfaction and therefore, his/her co-operation in preparation steps. In this study we have combined and assessed these two concepts on four groups of patients.

Methods:

Four hundred and seventy individuals with a variety of indications for colonoscopy were randomly allocated in 4 groups:

Group A:

115 patients receiving PEG in the day before + eating low residue diet;

Group B:

110 patients using PEG the day before + liquid diet only;

Group C:

split doses of PEG + low residue diet: 118 patients;

Group D:

split doses of PEG + liquids only: 111patients).

Quality of the colon cleaning was evaluated with Boston Bowel Preparation Scale.

Results:

There was no significant difference between the four groups in their age, sex, body mass index, usual bowel habit and indications for colonoscopy. Comparing the low residue versus liquid only regimens, mean Boston scores for left, transverse, right and total colon were higher for liquid only patients (2.22, 2.30, 2.12 and 6.11 vs. 2.36, 2.35, 2.38 and 7.11, respectively) (P < 0.05); however, we did not detect any significant difference in split versus day before colon preparations. Also, success in cecal intubation and total colonoscopy times were not different comparing split versus day before regimens.

Conclusions:

According to our results, these regimens can be used interchangeably with each other; however, the clear fluid induces a mild better colon preparation in comparison to low residue protocol.