Abstract
A Randomized Controlled Trial Comparing Efficacy of Lactulose Versus Low Volume Polyethylene Glycol (PEG) for Bowel Cleansing Prior to Colonoscopy.
Rolando Rabot Jr; Arlin Ong Go; Evan Ong; Alexander Uy;
Significance: Colonoscopy is the gold standard in evaluating the entire colonic mucosa. One factor for a successful procedure depends on the adequacy of bowel preparation. Low volume PEG is the standard bowel preparation; but it is seldom used due to poor palatability and higher volume. Lactulose, mixed with water to produce a lower volume of solution, has the advantage of being better tasting and has fewer side effects. This paper aims to compare the efficacy of oral lactulose solution versus low volume (2L) PEG as a bowel cleansing agent prior to colonoscopy.
Methodology: This is a single-center, randomized, observer-blinded study involving 74 patients who underwent elective colonoscopy using either lactulose or PEG as bowel preparation. Three endoscopists, who were blinded as to patients’ demographics, separately graded the recorded videos of the procedures according to Boston Bowel Preparation Scale (BBPS). The presence of adverse events during preparation, such as unpalatability of cleansing agent, abdominal discomfort or pain, bloatedness, and vomiting, were also analyzed.
Results: There were slightly more males than females (p=0.2389). The most common indication for colonoscopy is hematochezia, followed by abdominal pain, altered bowel pattern, and screening (p=0.8210). Lactulose was shown to be non-inferior to PEG as a bowel cleansing agent (BPPS 8.57 vs 8.38, p=0.1913). Detected adenoma was significantly higher in the lactulose group compared to the PEG group (72.97% vs 54.05%, p=0.0455). Lactulose was significantly more palatable as compared to PEG (p = < 0.00001)
Keywords: colonoscopy; lactulose; polyethylene glycol; bowel preparation
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |