One of the biggest complaints about having a colonoscopy is not about the procedure itself; it is the dreaded bowel prep. Drinking large volumes of liquid can make you feel uncomfortable, bloated and even nauseous. Now, with the split-dose (SPD) bowel preparation regimen, you can drink half of the laxative solution the night before your procedure and the other half on the morning of your procedure. This advancement has increased patient satisfaction and has helped gastroenterologists visualize the colon much more effectively.
The SPD has also had other benefits as well. Compared to using the single-dose preparation, split-dose patients have found that they experience:
- reduced intensity of bowel movements
- reduced duration of bowel movements
- less inconvenience
- improved bowel preparation
- increased sessile-serrated polyp detection rates
Nicholas Horton, M.D., of the Cleveland Clinic in Cleveland, Ohio, and colleagues conducted a prospective trial to compare bowel movements, sleep, travel disruptions, and adenoma detection rates in patients using the split-dose bowel preparation regimen and patients using the single-dose bowel preparation regimen.
Patients were divided into random groups and were instructed to use either a single-dose bowel preparation or a split-dose bowel preparation. They filled out surveys regarding the onset, duration, cessation and intensity of bowel movements, as well as sleep and travel disruption when going to the endoscopy center. Factors such as colon cleansing quality and polyp histology were also noted.
At the conclusion of the study, Dr. Horton found that the single-dose group reported greater duration and intensity of bowel movements than the split-dose group, and they also woke up for bowel movements more than the split-dose group. The quality of the bowel preparation in the split-dose group was also higher than the single-dose group.
There was no notable difference between the two groups in the need to stop driving on the way to the colonoscopy. Dr. Horton also found no difference in the adenoma detection rate between the two groups, but the detection rate of sessile-serrated polyps was almost four times higher in the split-dose group. This study was published in the American Journal of Gastroenterology (Source: MPR).