The association of beverage intake preference with bowel preparation laxative taste preference: Results of public taste tests

Purpose: There is a need to improve the bowel preparation experience of patients in order to increase the uptake of colorectal cancer screening. However, newer FDA approved products are typically not covered by healthcare insurance. Aim: To determine whether beverage intake preference can guide the selection of bowel laxative preparations which are usually covered by health insurance for patients undergoing colonoscopy to personalize laxative recommendations. Methods: We conducted seven public taste tests in Washington, DC, using commercially procured (A) unflavored polyethylene glycol (PEG), (B) orange flavored PEG, and (C) Moviprep which is a lemon flavored laxative. Volunteers completed baseline questionnaires including their beverage intake preferences (including use of sugar or sweeteners and cream or milk), tasted the laxatives in randomly assigned order and ranked the laxatives as 1st, 2nd, and 3rd based on their taste preferences. Our outcomes are the number of 1st place rankings for each laxative preparation. We used logistic regression models to compare the beverage intake characteristics of volunteers who chose each laxative as 1st to the rest of the volunteers and calculated odds ratios (OR) and 95% confidence intervals (CI). Results: A total of 670 volunteers participated in the taste tests: mean age = 44.4 years (range 18‐83 years), 56% female, 88.2% black, 48.2% had college education, 37.1% earn less than $25,000 per year, 35.4% obese (BMI >30kg/m2), 36.0% with history of smoking, and 60.5% had history of alcohol ingestion. The taste sequence was 34.5% ABC, 32.5% BCA and 33% CAB. Flavored PEG was ranked as first by 69.4% of volunteers (n=465) followed by Moviprep 20.8% (n=139) and unflavored PEG 9.9% (n=66). Overall, no beverage intake pattern for coffee, tea, and carbonated drinks (regular and diet) predicted the choice of unflavored PEG, flavored PEG and Moviprep. Conclusion: Beverage intake preference does not predict taste preference for bowel preparation laxatives. It is important to develop more tolerable bowel laxative preparations and make these preparations available to patients through their health insurance.