Comparison between Split Dose and Single Dose Bowel Laxatives for Preparation of Colonoscopy in Patients with Bangladeshi Diets: A Randomized Clinical Trial
Abstract
Introduction: Colonoscopy is an important diagnostic tool
for colonic disease and its efficacy and safety have been
correlated with adequate bowel preparation. This study
compared the efficacy and tolerability of single-dose and
split-dose sodium picosulfate lavage as a colon cleansing
agent for colonoscopy preparation.
Materials & Methods: This randomized clinical trial was conducted at
the Department of Gastroenterology in Sylhet MAG Osmani
Medical College Hospital, Sylhet, Bangladesh from June
2021 to May 2022.A total of 110 patients were selected by
randomized sampling technique who underwent elective
colonoscopy and were divided into split-dose (n=57) and
single-dose (n=53) laxative groups. Bowel preparation was
assessed by the Ottawa Bowel Preparation Scale (OBPS)
and data were analyzed by SPSS 24.0.
Result: The mean age of the patients was 47.4±17.7(SD)
years in split-dose and 47.6±15.9 (SD) years in single-dose
group. Both groups were statistically similar in terms of
socio-demographic profile, medical history, clinical
manifestation, and indication of colonoscopy (p>0.05).
The mean of total OBPS score (4.39±2.0 vs 5.56±2.2,
p=0.004) and caecal intubation time (6.60±3 vs 7.74±2.5,
p=0.035) was lower significantly in split-dose than the
single-dose group. However, colonoscopy findings, adverse
events, and patient compliance were similar between groups
(p>0.05).
Conclusion: Split-dose is superior to single-dose bowel
laxatives for colonoscopy preparation in terms of better
mucosal cleanliness and lower caecal intubation time.
However, further randomized controlled trial is recommended.