![]() ![]() To date, no bowel regimen meets all of these criteria. Additionally, it is unknown how much the feared discomfort of the bowel preparation experience dissuades patients from pursuing a screening colonoscopy for colon cancer.Īn ideal bowel preparation would reliably cleanse the colon in a rapid fashion, would not alter the colonic mucosa, result in an acceptable amount of patient discomfort, would not cause significant shifts in electrolytes and would be inexpensive. This translates into decreased effectiveness of the colonoscopy exam and often higher costs due to the need for repeat examination. Cleansing methods are variable, and often times high volume solutions are time consuming, inconvenient and uncomfortable, leading to poor patient compliance. This is often driven by the large volume of liquid required to be consumed, in addition to the poor palatability of some colon cleansing regimens. The bowel cleansing portion of the procedure is often the most lamented aspect of the colonoscopy experience. Bowel cleansing prior to colonoscopy is critical to the endoscopist obtaining optimal visualization during the procedure and therefore plays an integral role in safety, efficacy and diagnostic accuracy of the procedure. to determine if either preparation is associated with acute electrolyte disturbancesīackground Colonoscopy is the standard method for luminal evaluation of the colon.evaluate the effects of age, gender and tolerability on bowel prep quality.compare patient comfort and tolerability with each of the 2 preparation regimens. ![]() Primary aim: To compare the quality of bowel preparation between Miralax and Golytely This study is designed and powered to be an non-inferiority study. Objective To determine whether Miralax is as efficacious for bowel cleansing as standard Golytely for screening colonoscopy. Condition or diseaseĭrug: PEG-3350 and Gatorade Drug: Golytely 4 liters The investigators will check electrolytes to be sure patients do not develop hypokalemia with the Gatorade prep. The procedures will be done on healthy individuals referred for colon cancer screening and the exam will be billed to their insurance. The investigators will charge insurance companies for the prep - this is our current practice. This study will compare the efficacy of the two preps. The issue at present is that there has never been a blinded study to confirm these claims. The active ingredient, PEG, is not changed and therefore this is not surprising. Anecdotally there have been reports (case series) that it is far more palatable and the prep is equally efficacious. Conservatively, we estimate that 25% of colonoscopies in the US are being done with this prep. To overcome the limitation of existing preps, gastroenterologists and colorectal surgeons worldwide have been using PEG powder alone (same quantity as found in Golytely prep) not mixed with electrolytes (Glycolax or Miralax) and dissolving this into 64 ounces of Gatorade. The mixture is not very palatable due to the electrolyte additives which include sodium sulfate. Golytely) has been used for over two decades for colon cleansing. Polyethylene glycol (PEG) mixed with a balanced electrolyte solution (e.g. Fleets Phosphosoda) are now used on a limited basis because of their known association with renal injury. Why Should I Register and Submit Results?Ī major limitation to the widespread acceptance of colonoscopy as a procedure to screen for colorectal cancer is the laxative preparation. ![]()
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