The path to successful colonoscopy: a multi-center study on effective preparation regimens
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Aim : Colonoscopy is the gold standard for colorectal cancer screening and prevention. This multicenter study aims to evaluate and compare the effectiveness, cost-efficiency, and patient tolerability of different bowel preparation regimens for colonoscopy using a high-volume polyethylene glycol-based solution. Materials and methods : A total number of 746 patients were enrolled from three Bulgarian centers and were randomly assigned to various bowel preparation protocols categorized as previous-day, split-day, and same-day regimens. Effectiveness was assessed using the Boston Bowel Preparation Scale, cost-efficiency was determined by healthcare facility expenses, and patient tolerability was evaluated through patient-reported questionnaires. Results : The split-dose regimens achieved the highest bowel cleansing quality, significantly outperforming the other two groups. Furthermore, SPLIT4, one of the split-dose regimens, achieved the highest median Boston Bowel Preparation Scale (BBPS) score of 8, significantly outperforming previous-day and other split-dose protocols ( p <0.001), while maintaining excellent patient tolerability (mean score 1.25). Conclusion : Split-dose preparation using a high-volume polyethylene glycol solution demonstrated superior bowel cleansing and favorable patient tolerability, supporting current clinical guidelines. Future research should further investigate comparisons between high-volume and low-volume polyethylene glycol solutions to optimize patient adherence and outcomes.
Source: Folia Medica
Authors: Nikola Boyanov, Nikol Milinich, Aleksandar Balabanski, Katina Shtereva, Katerina Madzharova, Ivan Tishkov, Alexander Katzarov, Ivan Popadiyn, Galabina Hinkova, Stoilka Tufkova
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415615918