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Reviews on Recent Clinical Trials

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ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

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Clinical Trial

Lower Gastrointestinal Bleeding in the Emergency Department: High- Volume vs. Low-Volume Peg Bowel Preparation for Colonoscopy: A Randomized Trial

Author(s): Angela Saviano, Carmine Petruzziello, Maria Elena Riccioni, Marcello Di Pumpo, Martina Petrucci, Mattia Brigida, Christian Zanza, Marcello Candelli, Francesco Franceschi and Veronica Ojetti*

Volume 18, Issue 1, 2023

Published on: 08 November, 2022

Page: [76 - 81] Pages: 6

DOI: 10.2174/1574887117666220908152754

Price: $65

Abstract

Background: Lower Gastrointestinal Bleeding (LGIB) is a common cause of admission to the Emergency Department (ED). Early colonoscopy is the exam of choice for evaluating LGIB, and an adequate colon cleansing is essential. High-volume solution 4L-PEG is largely used, but it has some limitations. Low-volume solution 2L-PEG may improve patient’s tolerability and compliance, reducing the time of administration and speeding up the exam.

Patients and Methods: We conducted a randomized 1:1, prospective observational monocentric study in 228 patients (144M/84F) with LGIB. 121 (69M/52F) received the High-Volume, while 107 (75M/32F) received Low-Volume. They completed a “satisfaction questionnaire” (taste and smell, mood, time of taking, general experience). We collected the results of the Boston Bowel Preparation Scale (BBPS) and the final diagnosis.

The study was retrospectively registered on clinicaltrial.gov with protocol number NCT0536 2227.

Results: A mean value of BBPS 6,3 was achieved by both groups (p=0.57). Regarding smell, taste, mood and time of taking (1 to 5), we do not find any statistically differences. The overall satisfaction between the two preparations was 2.90 for low-volume compared to 3.17 for Highvolume (p=0.06). No side effects were reported. The proportion of patients without an evident source of bleeding was higher in High volume preparations compared to Low-volume (39% vs. 30%, respectively).

Conclusion: Low volume bowel preparation showed the same efficacy and tolerability with better satisfaction compared with high volume. Low-volume could represent an effective and more desirable preparation for patients in the ED.

Keywords: Colonoscopy, emergency department, BBPS, lower gastrointestinal bleeding, 2L-PEG, 4L-PEG.

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