A randomized controlled trial comparing polyethylene glycol solution plus prucalopride with polyethylene glycol solution alone on the efficacy of bowel preparation for colonoscopy

Background: Colonoscopy is currently the standard method for diagnosis and treatment for a number of colonic diseases. The patient needing colonoscopy has to undertake bowel preparation before the investigation. This process is very important as it can determine diagnostic accuracy and therapeutic success in the patients. Prucalopride is a substance that helps stimulate colonic movement. This study aimed to assess the effectiveness of the combination between prucalopride and polyethylene glycol solution (PEG-P) for bowel preparation before colonoscopy relative to PEG alone. Materials and Methods: This study used a prospective, randomized, double-blinded, controlled design. Eighty-six patients undergoing colonoscopy in Bhumibol Adulyadej Hospital were enrolled in the study (44 in PEG arm vs. 42 in PEG-P arm). The effectiveness of the colonic bowel preparation was assessed using Boston Bowel Preparation Score (BBPS), satisfaction, side effects and polyp detection rate also served as secondary outcomes. Results: PEG-P significantly showed better bowel preparation relative to PEG, as reflected by the higher BBPS in all parts of colons: caecum (2.1+0.6 vs. 1.6+0.7, p = 0.002), transverse colon (2.6+0.7 vs. 2.1+0.6, p = 0.001), sigmoid (2.8+0.6 vs. 2.4+0.6, p = 0.002) and rectum (2.8+0.6 vs. 2.4+0.6, p = 0.002). Five out of forty-two patients in the PEG-P arm had nausea and three had vomiting. Two patients in the PEG arm group had nausea and none had vomiting. The incidence of side effects in both arms did not show a statistically significant difference. PEG-P arm showed higher polyp detection rate than the PEG arm (59.5% vs. 36.4%, p = 0.032). Conclusion: PEG-P showed many preferable outcomes over PEG. These include better bowel cleansing and increasing the sensitivity of polyp detection with indifferent rate of side effects. With these advantages, the quality of life and compliance of the patients can be improved as repeated colonoscopy due to inadequate bowel preparation can be avoided.