Searching for ideal colonoscopy preparation: 2-L PEG plus ascorbic acid versus 4-L PEG plus simethicon: a randomized single blind clinical trial

Aim. The 2-L polyethylene glycol (PEG) lavage solution has been proved similarly safe and effective than 4-L PEG formulations in spite of the reduced volume. The aim of this paper was to compare low-volume polyethylene glycol (PEG)-based solution combined with ascorbic acid with high-volume PEG-based solution combined with simethicon in terms of efficacy and patient tolerability. Methods. This was a single blind prospective randomized trial. Patients were ramdomized to receive either 2-L PEG with ascorbic acid (PEG + Asc) or 4-L PEG plus simethicon (PEG + Sim). The primary endpoint was overall colon cleansing evaluation, assessed by blinded investigators using Aronchick Score. Secondary endpoints included patient compliance and tolerability and adverse events. Results. Sixty patients received PEG + Asc and sixty patients received PEG + Sim. Overall bowel cleansing score were considered adequate in 81.67% of the PEG + Asc and 80% of PEG + Sim groups, respectively. Excellent and good ratings were recorded in 11.6% and 38.3% receiving PEG + Asc compared to 26.6% and 23.3% of patients receiving PEG + Sim. Patient tolerability and safety were similar with both preparations. Conclusion. According to our data low-volume PEG + Asc has comparable efficacy, safety and tolerability as high-volume PEG + Sim so it can be considered a good alternative solution as a bowel preparation. More improvements are necessary in order to achieve the target of a perfect preparation.