Home E-Weekly August 17, 2010

Splitting the Dose Improves Bowel Prep Results

Published: August 16, 2010

Dividing a patient's intake of bowel prep solution results in a more effective cleansing for colonoscopy than if the solution were consumed all at once, and is also better tolerated, according to Italian researchers.

For a study published in the August issue of Gastrointestinal Endoscopy, the journal of the American Society for Gastrointestinal Endoscopy, the researchers observed the cases of 868 colonoscopy patients. While 433 were directed to consume the bowel prep solution as a standard single dose the day before the procedure, another 435 were prescribed a split-dosage schedule.

The endoscopists performing the procedures, who were not aware which prepping method their patients had undertaken, were asked to score each patient's level of bowel cleansing. The study reports that split-dose patients showed better cleansing results than single-dose patients, with 75.2% of split-dose patients scoring "good/excellent" as compared to 43% of the single-dose group.

The researchers also noted that cleaning scores dropped when colonoscopies were performed more than 8 hours after the patient completed the preparation process, leading them to suggest that late morning or afternoon might be an optimal time for split-dose colonoscopies.

The patients of both groups, split- and single-dose, prepped randomly with 1 of 2 different products, either the standard, high-volume, polyethylene glycol and electrolyte solution or a newer, low-volume polyethylene glycol and ascorbic acid solution. While the product that was consumed did not significantly affect the effectiveness of the cleansing, split-dose consumption was seen to provide the best prep for both products and patients reported that the low-volume product tasted better.

David Bernard

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