Transenteral Bowel Preparation for Colonoscopy Is More Comfortable than the Traditional Method with No Inferiority in Efficacy

Background Transenteral (TE) administration of a bowel cleanser prior to colonoscopy avoids the discomfort associated with drinking a large volume of unpalatable cleanser. Aim To explore patient comfort, preference for future colonoscopy, the efficacy and adverse events associated with TE bowel prep...

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Bibliographic Details
Published in:Digestive diseases and sciences 2015-01, Vol.60 (1), p.54-64
Main Authors: Jung, Sung-Won, Jung, Da Hye, Shin, Young Chul, Moh, In Ho, Yoo, Hana, Jang, Sung Il, Shin, Su Rin, Kim, Jin Bae, Park, Sang Hoon, Lee, Myung Seok
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Analysis
Ascorbic Acid - administration & dosage
Biochemistry
Cathartics - administration & dosage
Colonoscopy
Colonoscopy - methods
Endoscopy, Gastrointestinal
Female
Gastroenterology
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Methods
Middle Aged
Oncology
Organic acids
Original Article
Patient Satisfaction
Pneumoviridae
Polyethylene glycol
Polyethylene Glycols - administration & dosage
Polyols
Prospective Studies
Single-Blind Method
Transplant Surgery
Young Adult
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Summary:Background Transenteral (TE) administration of a bowel cleanser prior to colonoscopy avoids the discomfort associated with drinking a large volume of unpalatable cleanser. Aim To explore patient comfort, preference for future colonoscopy, the efficacy and adverse events associated with TE bowel preparation. Methods Bowel preparation is traditionally practised using polyethylene glycol (PEG) + ascorbic acid (ASC), which was the treatment used in the control group (peroral group; PO group). In the study group (TE group), PEG + ASC were administered directly to the third portion of the duodenum through a scope immediately after completing upper gastrointestinal endoscopy. Results A higher proportion of subjects in the TE group graded their degree of comfort as very or rather comfortable (28.4 % in the PO group, 65.1 % in the TE group; p  = 0.000) and had greater preference for future colonoscopy (69.6 % in the PO group, 82.5 % in the TE group; p  = 0.030), compared with the PO group. The TE group had non-inferiority in efficacy compared with the PO group (non-inferiority margin −15 %; lower limit of 95 % confidence interval for difference between success rates −6.4 %, when using the Aronchick Scale, and −7.1 % when using the Ottawa Scale). Nausea or vomiting were more prevalent during preparation in the PO group (46.1 vs. 17.5 %; p  = 0.000), and dizziness was more common in the TE group (0 vs. 12.6 %; p  = 0.000). Conclusions TE preparation was found to be more comfortable than the traditional peroral method and not inferior in efficacy. The adverse events rate was acceptable.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-014-3344-7