Polyethylene glycol-based bowel preparation before
colonoscopy for selected inpatients: A pilot study
Stefano PONTONE , Rossella PALMA, Cristina PANETTA, Chiara EBERSPACHER, Rita ANGELINI,
Daniele PIRONI, Angelo FILIPPINI & Paolo PONTONE
Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
OBJECTIVE: To evaluate the impact of a new same-
day, low-dose 1-L polyethylene glycol-based (1-L
PEG) bowel preparation on the diagnostic rating of
selected hospitalized patients and its tolerability,
with risk factors for inadequate bowel preparation.
METHODS: A single-center prospective pilot study
was conducted with hospitalized patients scheduled
for colonoscopy, presenting risk factors for poor
bowel preparation, such as bleeding or subocclusive
symptoms. The included patients were randomly
divided in two groups, which received either a same-
day 1-L PEG (group A) or a split-dose 4-L PEG
(group B), and performed a colonoscopy within 4 h
of the last dose.
RESULTS: In all, 44 inpatients [27 males; mean age
63.5 years (range 20–94 years)] were enrolled.
Optimal bowel cleansing was reached in 64% and
55% (P = 0.64) of patients in groups A and B, respec-
tively. The adenoma detection rate was 14% (group
A) and 18% (group B) (P = 0.34). A valid diagnosis
was reached in 38 (86%) of 44 patients (21 in group
A and 17 in group B) after a mean hospitalization of
3 days for group A and 6 days for group
B(P = 0.04).
CONCLUSIONS: Our data support the conclusion
that the schedule protocol proposed in this study
enables a clear diagnosis in most of the inpatients at
high risk of poor bowel preparation and no statistical
differences were found between the two groups in
terms of successful bowel cleansing achieved. There-
fore, the same-day, low-dose 1-L PEG bowel prepara-
tion could be introduced for selected inpatients.
KEY WORDS: Boston bowel preparation scale, Bristol scale, Colonic neoplasms, polyethylene glycols,
Colonoscopy represents the gold standard procedure
for the diagnosis of colorectal cancer, which is the
third most common cancer worldwide. It is also the
standard practice for lower gastrointestinal
(GI) bleeding or anemia.
The absence of solids or
residual brown liquid during an endoscopy, which
could mask a potential lesion, ensures adequate visu-
alization of the colonic mucosae. Suitable intestinal
cleaning is critical for the effectiveness and security of
the procedure. However, unfortunately, inadequate
bowel cleansing has been reported to be found in
approximately 20% of the participants who undergo
endoscopy, and is associated with a decreased detec-
tion rate of polyps and adenomas during the
Correspondence to: Stefano PONTONE, Department of Surgical
Sciences, Sapienza University of Rome, V.le Regina Elena 324, 00161
Rome, Italy. Email: email@example.com
Conﬂict of interest: None.
Accepted for publication 18 December 2017.
© 2017 Chinese Medical Association Shanghai Branch, Chinese
Society of Gastroenterology, Renji Hospital Afﬁliated to Shanghai
Jiaotong University School of Medicine and John Wiley & Sons
Journal of Digestive Diseases 2018; 19; 40–47 doi: 10.1111/1751-2980.12571