Reliable examination results can only be achieved during a colonoscopy if the bowel is sufficiently well cleaned. To achieve this, patients should drink two litres of PEG solution. Classically, this is done at two different times: one litre the day before the examination in the evening before going to bed and the second litre on the morning of the examination.
However, due to the rapid effect of PEG, many patients suffer from night-time discomfort after drinking the solution: Abdominal pain, flatulence and diarrhoea are the most common troublemakers at night.
The present study from India now investigated whether and how taking the laxative solution in the morning has an effect on bowel cleansing. For this purpose, colonoscopy patients with examination appointments in the late morning were randomised 1:1. Half followed the classic regimen, while the other half consumed both litres of the solution in the early morning hours prior to the colonoscopy.
The study authors found that those who only consumed PEG in the morning had a significantly better prepared, i.e. clean, bowel than those in the other group. This result was statistically significant.
Although the cleaning results were significantly better with a single dose in the morning than with distributed intake, the tolerance of the actual procedure of drinking the solution was the same in both groups. There were no significant differences in pain, diarrhoea and bloating. There was also no advantage in either study arm in terms of willingness to revisit.
However, significantly improved night sleep was noted in the morning group.
The administration of two litres of PEG in the morning of colonoscopy is a viable pathway for patients with late morning appointments. The study results show better bowel preparation and a more restful night's sleep. Overall, drinking was tolerated as well in this cohort as in the control group with staggered intake.