Effectiveness of 2-liter Split-dose versus 2-liter Non-split-dose Polyethylene Glycol for Bowel Preparation in Colonoscopy
Jirasak Inthasorn MD1, Kamin Harinwan MD1, Sakkarin Chirapongsathorn MD, MSc1, Krit Opuchar MD1, Theeranun Sanpajit MD1, Wanich Piyanirun MD1, Chaipichit Puttapitakpong MD1
Affiliation : 1 Division of Gastroenterology and Hepatology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
Background : Adequate bowel cleansing is essential for effective and safe colonoscopy. However, standard 4 liters or low
volume 2 liters bowel preparation regimen uses a lot of water that cause pain in patients.
Objective : To compare the degree of colon cleansing using 2-liter split-dosage and 2-liter non-split-dosage and evaluate the
outcome from bowel preparation.
Materials and Methods : This study was a single-blind, randomized study, which conducted in tertiary-care institutions. All
enrolled patients who underwent colonoscopy were randomized to receive 2-liter split-dose polyethylene glycol [PEG] or
2-liter non-split-dose PEG. The bowel preparation scale and questionnaires were evaluated after the procedure.
Results : One hundred and eighty patients were evaluated in this study, 91 patients received 2-liter split-dose and 89 patients
received 2-liter non-split-dose PEG. Boston bowel preparation scale [BBPS] scores were not significantly different in both
groups (8.7+0.6 in 2-liter spilt group vs. 8.6+0.6 in 2-liter non-split group, p = 0.25). Cecal intubation rate, willingness to
repeat colonoscopy and overall satisfaction were also not different in both groups. However, more patients chose 2-liter
spilt-dose regimen than 2-liter non-split regimen for the next colonoscopy (66.7% vs. 33.3%, p = 0.003).
Conclusion : Two-liter split-dose PEG was as effective as two-liter non-split-dosage for bowel cleansing in colonoscopy.
However, split dose has superior palatability compared to non-split dose.
Keywords : Boston bowel preparation scale, Bowel preparation, Colonoscopy, Non-split-dose, Polyethylene glycol, Split- dose
