Comparing Low Volume Versus Conventional Volume of Polyethylene Glycol for Bowel Preparation during Colonoscopy: A Randomised Controlled Trial
Authors:   Department of Surgery, School of Medical Science, Universiti Sains Malaysia, Kelantan, Malaysia, Othman Muhammad Faeid ,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan, Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Zakaria Andee Dzulkarnaen ,   Department of Surgery, School of Medical Science, Universiti Sains  Malaysia, Kelantan, Malaysia,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan, Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Yahya Maya Mazuwin ,   Department of Surgery, School of Medical Science, Universiti Sains  Malaysia, Kelantan, Malaysia,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan,  Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Md Hashim Mohd Nizam ,   Department of Surgery, School of Medical Science, Universiti Sains  Malaysia, Kelantan, Malaysia,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan,  Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Wan Mokhter Wan Mokhzani ,   Department of Surgery, School of Medical Science, Universiti Sains  Malaysia, Kelantan, Malaysia,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan, Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Wan Zain Wan Zainira ,   Department of Surgery, School of Medical Science, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan, Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia   Author 7 First Name: Ikhwan Sani  Last Name: Mohamad Organization1: Department of Surgery, School of Medical Science, Universiti Sains  Malaysia, Kelantan, Malaysia Organization2: Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan,  Malaysia, Mohamad Ikhwan Sani ,   Department of Surgery, School of Medical Science, Universiti Sains Malaysia, Kelantan, Malaysi,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan, Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Mohd Shah Mohd Shahrulsalam ,   Department of Surgery, School of Medical Science, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Syed Abd Aziz Syed Hassan ,   Department of Surgery, School of Medical Science, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan, Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Nik Ab Kadir Mohd Nasrullah ,   Department of Community Medicine, School of Medical Science, Universiti Sains Malaysia, Kelantan, Malaysia, Zakaria Zaidi ,   Department of Surgery, School of Medical Science, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan, Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Wong Michael Pak-Kai ,   Department of Surgery, School of Medical Science, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Surgery, Hospital Universiti Sains Malaysia, Kelantan, Malaysia,   Endoscopy Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Published: November 2023

Background: Polyethylene glycol (PEG) solution is widely used as a colonoscopic bowel cleaning agent, although some patients are intolerant due to the need for ingesting large solution volumes and unpleasant taste. A low-volume solution may enhance patient tolerability and compliance in bowel preparation. Accordingly, this study compared the effectiveness of two difference PEG volumes for bowel preparation before colonoscopy in terms of bowel cleanliness, completeness of colonoscopy, patient tolerability and colonoscopy duration. Methods: Using a prospective randomised controlled single-blinded study design, 164 patients scheduled for colonoscopy were allocated to two groups (n = 82 patients in each) to receive either the conventional PEG volume (3 L, control group) or the low volume (2 L, intervention group). The Boston Bowel Preparation Scale (BBPS), a validated scale for assessing bowel cleanliness during colonoscopy, was used to score bowel cleanliness in three colon segments. Secondarily, colonoscopy completeness, tolerability to drinking PEG and the duration of colonoscopy were compared between the groups. Results: There were no statistically significant differences between the two intervention groups in terms of bowel cleanliness (P = 0.119), colonoscopy completion (P = 0.535), tolerability (P = 0.190) or the amount of sedation/analgesia required (midazolam, P = 0.162; pethidine, P = 0.708). Only the duration of colonoscopy differed between the two groups (longer duration in the control group, P = 0.039). Conclusion: Low-volume (2 L) PEG is as effective as the standard 3 L solution in bowel cleaning before colonoscopy; however, the superiority of either solution could not be established.