Pontone S, Angelini R, Standoli M, Patrizi G, Culasso F, Pontone P, Redler A. Low-volume plus ascorbic acid vs high-volume plus simethicone bowel preparation before colonoscopy. World J Gastroenterol 2011; 17(42): 4689-4695 [PMID: 22180711 DOI: 10.3748/wjg.v17.i42.4689]
Corresponding Author of This Article
Dr. Stefano Pontone, Department of Surgical Sciences, “Sapienza” University of Rome, V le Regina Elena 324, 00161 Rome, Italy. stefano.pontone@uniroma1.it
Article-Type of This Article
Brief Article
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World J Gastroenterol. Nov 14, 2011; 17(42): 4689-4695 Published online Nov 14, 2011. doi: 10.3748/wjg.v17.i42.4689
Table 1 Patient demographics, indications and colonoscopy findings
PEG + Asc
PEG + Sim
ITT patients
72
72
Compliant patients (%)
69 (96)
61 (85)
Cecal intubation (%)
62 (86)
68 (94)
Median age (range)
60.1 (20-84)
57.6 (33-81)
Male (%)
40 (55)
36 (50)
Median timing of colonoscopy (min)
22
21
Indications (%)
Follow-up
27 (37)
18 (25)
Surveillance
8 (11)
11 (15)
CRC sreening
15 (21)
8 (11)
Hematochezia
13 (18)
16 (22)
Change in bowel habits
3 (4)
7 (10)
Anemia
2 (3)
1 (2)
Abdominal pain
4 (6)
11 (15)
Findings (%)
No abnormalities
40 (55)
24 (33)
Diverticular disease
14 (19)
14 (19)
Polyps/Malignancy
13/2 (18/3)
22/0 (31/0)
IBD
1 (2)
3 (4)
Other
2 (3)
9 (13)
Table 2 Colonoscopy preparation schedules
PEG + Asc
2 L from 6:00 to 8:00 PM (250 mL every 15 min) plus 500 mL of clear fluid for every L of solution, evening before colonoscopy
Each liter of PEG + Asc (MoviPrep®) contains 100 g macrogol 3350, 7.5 g sodium sulfate, 2.7 g sodium chloride, 1 g potassium chloride, 4.7 g ascorbic acid, 5.9 g sodium ascorbate, and lemon flavoring
PEG + Sim
2 L from 3:00 to 5:00 PM and 2 L from 6:00 to 8:00 PM (250 mL every 15 min), evening before colonoscopy
Each liter of PEG + Sim (Selg®-Esse 1000) contains 58.3 g macrogol 4000, 0.08 g simethicone, 5.68 g sodium sulfate, 1.68 g sodium bicarbonate, 1.46 g sodium chloride and 0.74 g potassium chloride and mandarin aroma
Table 3 Colonoscopy preparation assessments
Aronchick scale
1 Excellent
Small volume of clear liquid or greater than 95% of surface seen
2 Good
Large volume of clear liquid covering 5% to 25% of surface but greater than 90% of surface seen
3 Fair
Some semi-solid stool that could be suctioned or washed away but greater than 90% of surface seen
4 Poor
Semi-solid stool that could not be suctioned or washed away and less than 90% of surface seen
5 Inadequate
Repreparation needed
Residual stool score (total in sum of three score)
Amount of residual stool
0 = none
1 = small
2 = moderate
3 = large
Consistency of residual stool
0 = none
1 = clear liquid
2 = colored liquid
3 = stool particles
4 = semi-solid stool
5 = solid stool
Percent bowel wall visualized
0 ≥ 75%
1 = 50%-75%
2 = 25%-49%
3 ≤ 25%
Table 4 Patient drop-out: global bowel cleansing, side effects and findings
Drop out gut cleansing
PEG + Asc
PEG + Sim
No. of patients
3
11
Global bowel cleansing (%)
Aronchick 1
(1)
(2)
Aronchick 2
(1)
(5)
Aronchick 3
-
(2)
Aronchick 4
(1)
(2)
Aronchick 5
-
-
Cecal Intubation (patients)
2
11
Findings
No abnormalities
1
9
Polyps/malignancy
0/1
2/0
Diverticular disease
1
-
Other
-
Table 5 Side effects in compliant patients (1multiple side effects possible)
PEG + Asc
PEG + Sim
No. of patients
72
72
Side effects patients1
14
21
Nausea
7
16
Vomiting
4
5
Headache
3
1
Insomnia
1
1
Abdominal pain
2
1
Table 6 Overall gut cleansing and cecal intubation performed
Overall gut cleansing
PEG + Asc
PEG + Sim
No. of patients
69
61
Aronchick 1
8/5
17/16
Aronchick 2
29/27
13/12
Aronchick 3
26/26
24/24
Aronchick 4
5/2
5/5
Aronchick 5
1/0
2/0
Table 7 Patient questionnaire findings by preparation group tolerability
Question
PEG + Asc
PEG + Sim
Clear liquid at the time of the last evacuation
Yes
51
62
No
21
10
Is this the first time you took a preparation for colonoscopy?
Yes
33
43
No
39
29
Discomfort:
None
18
28
Slightest
32
36
Moderate
17
6
Severe
5
2
How much would you be prepared to repeat this preparation for colonoscopy?
A little
18
15
Fairly
32
42
Much
15
11
I would never repeat
7
4
Citation: Pontone S, Angelini R, Standoli M, Patrizi G, Culasso F, Pontone P, Redler A. Low-volume plus ascorbic acid vs high-volume plus simethicone bowel preparation before colonoscopy. World J Gastroenterol 2011; 17(42): 4689-4695