CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(05): E617-E622
DOI: 10.1055/a-1118-3526
Original article

Comparison of patterns of laxative ingestion to improve bowel preparation for colonoscopy: a pilot randomized clinical trial[*]

Adeyinka O. Laiyemo
1  Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, United States
,
Kolapo A. Idowu
2  Department of Medicine, Johns Hopkins Medicine, Baltimore, Maryland, United States
,
Clinton Burnside
3  Howard University Cancer Center, Washington, District of Columbia, United States
,
Carla D. Williams
3  Howard University Cancer Center, Washington, District of Columbia, United States
,
Momodu Jack
1  Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, United States
,
Getachew Mekasha
1  Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, United States
,
Hassan Ashktorab
1  Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, United States
,
Hassan Brim
4  Department of Pathology, Howard University, Washington, District of Columbia, United States
,
Edward L. Lee
4  Department of Pathology, Howard University, Washington, District of Columbia, United States
,
Andrew K. Sanderson
5  Graduate School, Howard University, Washington, District of Columbia, United States
,
Angesom Kibreab
1  Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, United States
,
John Kwagyan
6  Georgetown-Howard Universities Center for Clinical and Translations Science, Washington, District of Columbia, United States
› Author Affiliations
This study was funded by the Bridge Funds and Pilot Study Awards Program (Grant number U400043) from Howard University.

TRIAL REGISTRATION: single-center, single-blind (endoscopist), parallel design, prospective, three-arm randomized trial NCT02062112 at clinicaltrials.gov
  

Abstract

Background and study aims Negative experiences with bowel preparation are a barrier to uptake of colonoscopy. The aim of this study was to examine the impact of different flavoring of polyethylene glycol (PEG) laxatives on patient satisfaction with and adequacy of bowel preparation during colonoscopy.

Patients and methods This was a single-blind (endoscopist), parallel design, randomized trial (NCT 02062112) during which patients scheduled for colonoscopy were assigned to one of three groups: Group 1 (no laxative flavoring, n = 84); Group 2 (flavored entire laxative, n = 90) and Group 3 (tasted PEG with and without flavoring and decided how they want to drink the rest of the laxatives (choice group), n = 82). Patients rated their bowel preparation experience (satisfaction) and endoscopists accessed adequacy of bowel preparation during colonoscopy.

Results There were no differences in patient ratings across the groups (1, 2 and 3) in taste of the laxatives (P = 0.67), ease of drinking (P = 0.53), and overall experience of bowel preparation process (P = 0.18). However, higher percentage of patients in the choice group would want the same laxative again if they were going to have a repeat colonoscopy in the future (72.5 % vs 81.3 % vs 88.9 %, P = 0.04). Surprisingly, adequacy of bowel preparation was highest among patients who drank their PEG unflavored (89.3 % vs 80 % vs 75.5 %, P = 0.07) and the had highest rates of adenoma detection (40.5 % vs 23.3 vs 39.0, P = 0.03).

Conclusions There were no differences in overall tolerability of bowel preparation by patterns of flavoring of PEG. Those who drank unflavored PEG were less satisfied but had better clinical outcome, suggesting minimum justification effect in bowel preparation process.

* Meeting presentations: An abstract from this study was presented at the American College of Gastroenterology Meeting in Honolulu, Hawaii in October 2015. [Am J Gastroenterol 2015; 110 (1): S567].




Publication History

Received: 04 September 2019

Accepted: 08 January 2020

Publication Date:
17 April 2020 (online)

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