Clinical Trials Study
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World J Gastrointest Endosc. Dec 16, 2014; 6(12): 606-611
Published online Dec 16, 2014. doi: 10.4253/wjge.v6.i12.606
Comparison of split-dosing vs non-split (morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy
Hardik Shah, Devendra Desai, Hrishikesh Samant, Sandeep Davavala, Anand Joshi, Tarun Gupta, Philip Abraham
Hardik Shah, Devendra Desai, Hrishikesh Samant, Sandeep Davavala, Anand Joshi, Tarun Gupta, Philip Abraham, Division of Gastroenterology, P D Hinduja National Hospital, Mumbai 400016, Maharashtra, India
Author contributions: Shah H planned the study protocol and main write up of the article with screening of patients and assessing the bowel preparation; Desai D helped in write up of the article and screening of patients; Samant H and Davavala S helped in enrolling patients for the study and screening them; Joshi A, Gupta T and Abraham P valuable contribution for patient enrollment, screening and editing the article.
Correspondence to: Devendra Desai, DNB (Gastroenterology), Consultant Gastroenterologist, Division of Gastroenterology, P D Hinduja National Hospital, Veer Savarkar Marg, Mumbai 400016, Maharashtra, India. devendracdesai@gmail.com
Telephone: +91-932-2596152 Fax: +91-022-24440425
Received: May 15, 2014
Revised: September 11, 2014
Accepted: October 31, 2014
Published online: December 16, 2014
Processing time: 217 Days and 6 Hours
Abstract

AIM: To compare (using the Ottawa Bowel Preparation Scale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the optimal preparation-to-colonoscopy interval.

METHODS: Single-centre, prospective, randomized, investigator-blind stud in an academic tertiary-care centre. Two hundred patients requiring elective colonoscopy were assigned to receive one of the two preparation regimens (split vs morning) prior to colonoscopy. Main outcome measurements were bowel preparation quality and patient tolerability.

RESULTS: Split-dose regimen resulted in better bowel preparation compared to morning regimen [Ottawa score mean 5.52 (SD 1.23) vs 6.02 (1.34); P = 0.017]. On subgroup analysis, for afternoon procedures, both the preparations were equally effective (P = 0.756). There was no difference in tolerability and compliance between the two regimens.

CONCLUSION: Overall, previous evening - same morning split-dosing regimen results in better bowel cleansing for colonoscopy compared to morning preparation. For afternoon procedures, both schedules are equally effective; morning preparation may be more convenient to the patient.

Keywords: Bowel preparation; Colonoscopy; Morning preparation; Split dose preparation; Preparation to colonoscopy interval

Core tip: Split bowel reparation compared to single dose morning preparation resulted in a better bowel cleansing using the Ottawa Bowel Preparation Scale. The average score (± SD) using the Ottawa Scale was 6.02 ± 1.34 when morning preparation was given and 5.52 ± 1.23 when split preparation was given (P = 0.017). However, there was no statistical difference in the mean Ottawa score when the procedures were done in the afternoon with either the morning or the split preparation (6.09 vs 5.94, P = 0.756). Hence, AM only dosing is as effective as split dosing for patients scheduled for a colonoscopy in the afternoon.