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Comparison of the Effectiveness of Bowel Preparations Before Colonoscopy

Not Applicable
Conditions
Colorectal Neoplasms
Interventions
Procedure: colonoscopy
Registration Number
NCT03242369
Lead Sponsor
Military University Hospital, Prague
Brief Summary

Polyethylene glycol is the gold standard of bowel preparation for colonoscopy. The most important disadvantage is high volume of this preparation. Sulphate based solution (SBS), low volume PEG + ascorbic acid and solution of magnesium citric acid and sodium picosulfate could be suitable substitution of polyethylene glycol.

Detailed Description

This study will be unicenter, randomized and single blind. It focuses on studying the effectiveness of four preparations for bowel cleansing before colonoscopy. Polyethylenglycol (PEG) will be compared as a gold standard of bowel cleansing with low volume preparations: Sulfate-based solution (SBS), low volume PEG + ascorbic acid and solution of magnesium citric-acid and sodium picosulfate. The effectiveness will be rated according to a quality of bowel preparation (Boston Bowel Preparation Scale) and detection of a colorectal neoplasia. The aim of this project is to compare the effectiveness of each four preparations.

Primary endpoint: To compare a quality of bowel preparation. Secondary endpoint: To compare a detection of colorectal neoplasia in those preparations.

Main hypothesis: PEG as a gold standard of bowel cleansing preparation is not worse than the other compared preparations.

Secondary hypothesis: PEG is not worse in detection of colorectal neoplasia than the other compared preparations.

Methods: There will be 400 patients included in the project with all indications for colonoscopy (age ≥ 18 years, no upper age limit) except the exclusion criteria. The patients will be offered to participate in the study at the Endoscopy unit when arranging the examination. In case of agreement they will sign informed consent and they will be educated about the correct process of bowel preparation. They also get all the instructions in printed version and questionnaire of preparation tolerability. The advantages for the patients in study will be earlier date of colonoscopy. On the day of colonoscopy, the patients will submit the questionnaire and undergo standard colonoscopy examination.

The quality of a bowel cleansing will be evaluated by the experienced endoscopists who will be blinded about a type of bowel preparation. The effectiveness will be assessed by the degree of bowel cleansing (Boston Bowel Preparation Scale) and ADR, aADR and number of cancers diagnosed. The GE unit staff will record all results in the on-line study database. Results will be statistically evaluated in Institute of Biostatistics and Analyses, Masaryk University, IBA MU).

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
400
Inclusion Criteria

• Individuls ≥ 18 years old undergoing colonoscopy for all indications except exclusion criteria

Exclusion Criteria
  • Active idiopathic bowel disease
  • Chronic renal insufficiency
  • Serious internal comorbidity
  • Planned therapeutic colonoscopy
  • No informed consent signed (with the study and/or with the colonoscopy)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
SBS groupcolonoscopy100 patients undergoing colonoscopy
PICO groupcolonoscopy100 patients undergoing colonoscopy.
PEG groupcolonoscopy100 patients undergoing colonoscopy.
PEG 2L + ascorbic acid groupcolonoscopy100 patients undergoing colonoscopy.
Primary Outcome Measures
NameTimeMethod
Quality of bowel cleansing according to Boston Bowel Preparation Scale (BBPS)1 day

* 0-Unprepared colon segment with mucosa not seen due to solid stool that cannot be cleared

* 1-Portion of mucosa of the colon segment seen, but other areas of the segment are not well seen due to staining, residual stool, and/or opaque liquid

* 2-Minor amount of residual staining, small fragments of stool and/or opaque liquid, but mucosa colon segment is seen well

* 3-Entire mucosa of colon segment seen well, with no residual staining, small fragment of stool or opaque liquid

Secondary Outcome Measures
NameTimeMethod
Detection of colorectal neoplasia1 day

In each colonoscopy the number of colorectal neoplasia will be rated.

Colorectal neoplasia is defined by these two types of lession:

* advanced adenoma - 1cm size or greater or with villous component or with high grade dysplasia

* carcinoma

Trial Locations

Locations (1)

Military University Hospital

🇨🇿

Prague, Czechia

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