Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2017; 23(6): 1030-1037
Published online Feb 14, 2017. doi: 10.3748/wjg.v23.i6.1030
Is a split-dose regimen of 2 L polyethylene glycol plus ascorbic acid tolerable for colonoscopy in an early morning visit to a comprehensive medical check-up?
Ji Yeon Seo, Changhyun Lee, Eun Hyo Jin, Mi Hyun Yun, Joo Hyun Lim, Hae Yeon Kang, Jong In Yang, Su Jin Chung, Sun Young Yang, Joo Sung Kim
Ji Yeon Seo, Changhyun Lee, Eun Hyo Jin, Joo Hyun Lim, Hae Yeon Kang, Jong In Yang, Su Jin Chung, Sun Young Yang, Joo Sung Kim, Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 06236, South Korea
Mi Hyun Yun, Department of Nursing, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 06236, South Korea
Author contributions: Seo JY, Lee C, Chung SJ and Kim JS designed the study; Seo JY, Lee C, Jin EH, Yun MH, Lim JH, Kang HY, Yang JI and Yang SY performed the research; Seo JY analyzed the data; Seo JY and Lee C wrote the paper; and Chung SJ, Yang SY and Kim JS critically revised the manuscript for important intellectual content.
Institutional review board statement: This study was approved by the Ethical Committee at SNUH (Seoul National University Hospital, IRB No. H-1601-007-729).
Informed consent statement: Informed consent was waived by Ethical Committee at SNUH.
Conflict-of-interest statement: The authors have no conflict of interest.
Data sharing statement: The dataset is available from the corresponding author at mdchlee@gmail.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Changhyun Lee, MD, Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, 737 Yeoksam-dong, Gangnam-Gu, Seoul 06236, South Korea. mdchlee@gmail.com
Telephone: +82-2-21125578 Fax: +82-2-21125635
Received: December 1, 2016
Peer-review started: December 6, 2016
First decision: December 20, 2016
Revised: December 27, 2016
Accepted: January 17, 2017
Article in press: January 17, 2017
Published online: February 14, 2017
Abstract

AIM

To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.

METHODS

From February 2015 to March 2015, examinees of average risk who were scheduled for a colonoscopy in the morning were retrospectively enrolled.

RESULTS

The 189 examinees were divided into split-dose and non-split-dose groups. The adequacy of bowel preparation for the split-dose group vs the non-split-dose group was 96.8% vs 85.2%, respectively, P < 0.001, and the compliance of the last meal restriction was 74.6% vs 58.2%, respectively, P < 0.001. The sleep disturbance (P < 0.001) was more prevalent in the split-dose group, however the willingness to repeat the same preparation method (P = 0.243) was not different in both groups. The split-dose regimen was the most important factor influencing adequate bowel preparation in multivariate analysis (HR = 10.89, 95%CI: 6.53-18.17, P < 0.001).

CONCLUSION

A split-dose regimen of 2 L PEG/AA for an early morning colonoscopy was more effective and showed better compliance for diet restriction without any difference in satisfaction and discomfort. Introducing a split-dose regimen of 2 L PEG/AA to morning colonoscopy examinees is effective and tolerable in a comprehensive medical check-up setting.

Keywords: Compliance, Early morning colonoscopy, Effectiveness, Split-dose regimen, Tolerability

Core tip: A split-dose regimen of 2 L polyethylene glycol plus ascorbic acid is not widely used in comprehensive medical check-up, because this is considered intolerable for an early morning visit. We performed a retrospective cohort study to evaluate the effectiveness and tolerability of split-dose regimen for early morning visitors. A split-dose regimen for an early morning colonoscopy was more effective in bowel cleansing and showed better compliance for diet restriction compared with non-split-dose regimen without any difference in satisfaction and discomfort. Therefore, introducing a split-dose regimen to morning colonoscopy examinees is effective and tolerable even in comprehensive medical check-up settings.