Colonoscopy preparation drugs taken in full the day of the procedure are as effective as split doses taken both the night before and the morning of the procedure, but have fewer negative effects on patients' quality of life, according to researchers.

In a single-center, randomized study of 116 patients undergoing afternoon outpatient colonoscopy, 62 patients received morning-only polyethylene glycol electrolyte solution on the day of surgery, while 54 received split-dose PEG-ELS. Efficacy rates in terms of providing the physician with a clear view of the colon during the procedure were about equal (above 90%) in both groups, according to the research team led by David Kastenberg, MD, of Thomas Jefferson University in Philadelphia.

The 2 secondary outcomes studied — tolerance and polyp detection — actually favored the morning-only dosage. Polyp detection was better in the morning-only prep group, while those patients also had fewer complaints of abdominal pain and interference with sleep and previous workday performance. The rate of overall adverse effects was not significantly different between the 2 groups.

"The real advantage of the morning prep is it has less interference on the patient's quality of life," says Dr. Kastenberg of the findings, which were published in the American Journal of Gastroenterology. "Perception is also key. Patients may well tolerate the colon prep and procedure better if it's a one-day event versus two."

Irene Tsikitas

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