Randomized Controlled Trial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2015; 21(10): 3041-3048
Published online Mar 14, 2015. doi: 10.3748/wjg.v21.i10.3041
Electrolyte changes after bowel preparation for colonoscopy: A randomized controlled multicenter trial
Kyong Joo Lee, Hong Jun Park, Hyun-Soo Kim, Kwang Ho Baik, Yeon Soo Kim, Sung Chul Park, Hyun Il Seo
Kyong Joo Lee, Hong Jun Park, Hyun-Soo Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 220-701, South Korea
Kwang Ho Baik, Yeon Soo Kim, Department of Internal Medicine, Hallym University, Chuncheon Sacred Heart Hospital, Chuncheon 200-704, South Korea
Sung Chul Park, Department of Internal Medicine, Kangwon National University Hospital, Chuncheon 200-722, South Korea
Hyun Il Seo, Department of Internal Medicine, Ulsan Medical University, Gangneung Asan Hospital, Gangneung 210-711, South Korea
Author contributions: Lee KJ and Park HJ equally contributed to this work; Park HJ and Kim HS designed the research; Park HJ, Kim HS, Baik KH, Kim YS, Park SC and Seo HI performed endoscopic procedures; Lee KJ and Park HJ analysed the data and wrote the paper; and Kim HS revised the final draft; all authors have read and approved the final manuscript.
Supported by National R and D Program for Cancer Control, Ministry of Health and Welfare, South Korea, No. 1220230; and Taejun Pharmaceutical Company, South Korea.
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: Hyun-Soo Kim, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Ilsanro 20, Wonju City 220-701, Kangwondo, South Korea. hyskim@yonsei.ac.kr
Telephone: +82-33-7411224 Fax: +82-33-7411228
Received: August 4, 2014
Peer-review started: August 5, 2014
First decision: August 27, 2014
Revised: September 29, 2014
Accepted: December 14, 2014
Article in press: December 16, 2014
Published online: March 14, 2015
Processing time: 223 Days and 22 Hours
Abstract

AIM: To investigate the electrolyte changes between 2-L polyethylene glycol with ascorbic acid 20 g (PEG-Asc) and 4-L PEG solutions.

METHODS: From August 2012 to February 2013, a total of 226 patients were enrolled at four tertiary hospitals. All patients were randomly allocated to a PEG-Asc group or a 4-L PEG. Before colonoscopy, patients completed a questionnaire to assess bowel preparation-related symptoms, satisfaction, and willingness. Endoscopists assessed the bowel preparation using the Boston Bowel Preparation Scale (BBPS). In addition, blood tests, including serum electrolytes, serum osmolarity, and urine osmolarity were evaluated both before and after the procedure.

RESULTS: A total of 226 patients were analyzed. BBPS scores were similar and the adequate bowel preparation rate (BBPS ≥ 6) was not different between the two groups (PEG-Asc vs 4-L PEG, 73.2% vs 76.3%, P = 0.760). Bowel preparation-related symptoms also were not different between the two groups. The taste of PEG-Asc was better (41.1% vs 16.7%, P < 0.001), and the willingness to undergo repeated bowel preparation was higher in the PEG-Asc group (73.2% vs 59.3%, P = 0.027) than in 4-L PEG. There were no significant changes in serum electrolytes in either group.

CONCLUSION: In this multicenter trial, bowel preparation with PEG-Asc was better than 4-L PEG in terms of patient satisfaction, with similar degrees of bowel preparation and electrolyte changes.

Keywords: Colonoscopy; Bowel preparation; Ascorbic acid; Polyethylene glycol; Electrolyte

Core tip: Two-liter polyethylene glycol solution with ascorbic acid (PEG-Asc) is widely used as a bowel preparation solution but few studies concern about electrolytes imbalance, especially for Asian population. In this study, we compared PEG-Asc with 4-L PEG and revealed that there were no significant electrolyte changes after intake of solution in the both groups. In addition, the efficacy of bowel preparation by PEG-Asc was equally effective as 4-L PEG and more patients felt better tolerance in PEG-Asc group. Therefore, PEG-Asc can be better option than 4-L PEG.