Comparison of Four Different Colonic Preps in 3595 Patients at a University Center: A Real Life Experience

Abstract

Aim:Several bowel preps are currently used for colonoscopy but only limited data are available comparing the different products.

Methods: We retrospectively reviewed all colonoscopies performed at Georgetown U. Hospital from May 2013 to May 2014. A 9-point modified Boston Bowel Preparation Scale (BBPS) was utilized (best score = 9) by experienced endoscopists. Colonoscopies without a BBPS score were excluded.

Results: Four preps and their percentage usage were 4-L PEG solutions (Golytely® or Colyte®) (50%), PEG with bisacodyl tablets (Miralax®) (17%), PEG with ascorbic acid (Moviprep®) (8%), sodium picosulfate (Prepopik®) (25%), with the following overall BBPS scores respectively: 7.45, 7.45, 7.40, 7.55. Statistical superiority of split-doseto day-prior dose was seen for Golytely®/Colyte®, Miralax®, and Moviprep® with a trend seen for Prepopik®. Comparison of each prep by split and prior day dosing showed a significantly higher score only for Golytely®/Colyte® and Prepopik® vs Moviprep® given prior day dosing. A higher BBPS score was seen for women vs men overall for both split-dose and day-prior dosepreps (with the exception of Moviprep® in PD preps). Higher scores were seen for a.m. procedures but were not significant. All preps had lower scores in the right colon, regardless of being split-dose or day-prior dose.

Conclusions: This real world experience in nearly 3600 patients confirms that split dosing is superior to day-prior dosing. We found women had higher BBPS scores than men but no differences were seen between morning and afternoon procedures. All preps were relatively comparable, however differences in price may be an important decision-maker.