A Randomized Controlled Trial Comparing Polyethylene Glycol Solution Plus Prucalopride with Polyethylene Glycol Solution Alone on the Efficacy of Bowel Preparation for Colonoscopy
Kerdsin S, MD1, Sutthivana C, MD1, Suphanchaimat R, MD2,3, Thammatacharee N, PhD4
Affiliation : 1 Gastroenterology and Hepatology Department, Bhumibol Adulyadej Hospital, Bangkok, Thailand 2 International Health Policy Program Thailand, Ministry of Public Health, Nonthaburi, Thailand 3 Epidemiology Division, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand 4 Health Systems Research Institute, Nonthaburi, Thailand
Background : Colonoscopy is currently the standard method for diagnosis and treatment for a number of colonic diseases. The
patient needing colonoscopy has to undertake bowel preparation before the investigation. This process is very important as it can
determine diagnostic accuracy and therapeutic success in the patients. Prucalopride is a substance that helps stimulate colonic
movement. This study aimed to assess the effectiveness of the combination between prucalopride and polyethylene glycol solution
(PEG-P) for bowel preparation before colonoscopy relative to PEG alone.
Materials and Methods : This study used a prospective, randomized, double-blinded, controlled design. Eighty-six patients undergoing
colonoscopy in Bhumibol Adulyadej Hospital were enrolled in the study (44 in PEG arm vs. 42 in PEG-P arm). The effectiveness of
the colonic bowel preparation was assessed using Boston Bowel Preparation Score (BBPS), satisfaction, side effects and polyp
detection rate also served as secondary outcomes.
Results : PEG-P significantly showed better bowel preparation relative to PEG, as reflected by the higher BBPS in all parts of colons:
caecum (2.1+0.6 vs. 1.6+0.7, p = 0.002), transverse colon (2.6+0.7 vs. 2.1+0.6, p = 0.001), sigmoid (2.8+0.6 vs. 2.4+0.6, p = 0.002) and
rectum (2.8+0.6 vs. 2.4+0.6, p = 0.002). Five out of forty-two patients in the PEG-P arm had nausea and three had vomiting. Two
patients in the PEG arm group had nausea and none had vomiting. The incidence of side effects in both arms did not show a statistically
significant difference. PEG-P arm showed higher polyp detection rate than the PEG arm (59.5% vs. 36.4%, p = 0.032).
Conclusion : PEG-P showed many preferable outcomes over PEG. These include better bowel cleansing and increasing the sensitivity
of polyp detection with indifferent rate of side effects. With these advantages, the quality of life and compliance of the patients can
be improved as repeated colonoscopy due to inadequate bowel preparation can be avoided.
Keywords : Prucalopride, Polyethylene glycol solution, Colonoscopy, Bowel preparation, Boston bowel preparation score
