AIM:To compare the efficacy and palatability of 4L polyethylene glycol electrolyte(PEG)plus sugar-free menthol candy(PEG+M)vs reduced-volume 2 L ascorbic acid-supplemented PEG(Asc PEG).METHODS:In a randomized controlled trial setting,ambulatory patients scheduled for elective colonoscopy were prospectively enrolled.Patients were randomized to receive either PEG+M or Asc PEG,both splitdosed with minimal dietary restriction.Palatability was assessed on a linear scale of 1 to 5(1=disgusting;5=tasty).Quality of preparation was scored by assignment-blinded endoscopists using the modified Aronchick and Ottawa scales.The main outcomes were the palatability and efficacy of the preparation.Secondary outcomes included patient willingness to retake the same preparation again in the future and completion of the prescribed preparation.RESULTS:Overall,200 patients were enrolled(100patients per arm).PEG+M was more palatable than Asc PEG(76%vs 62%,P=0.03).Completing the preparation was not different between study groups(91%PEG+M vs 86%Asc PEG,P=0.38)but more patients were willing to retake PEG+M(54%vs 40%respectively,P=0.047).There was no significant difference between PEG+M vs Asc PEG in adequate cleansing on both the modified Aronchick(82%vs77%,P=0.31)and the Ottawa scale(85%vs 74%,P=0.054).However,PEG+M was superior in the left colon on the Ottawa subsegmental score(score0-2:94%for PEG+M vs 81%for Asc PEG,P=0.005)and received significantly more excellent ratings than Asc PEG on the modified Aronchick scale(61%vs 43%,P=0.009).Both preparations performed less well in afternoon vs morning examinations(inadequate:29%vs 15.2%,P=0.02).CONCLUSION:4 L PEG plus menthol has better palatability and acceptability than 2 L ascorbic acidPEG and is associated with a higher rate of excellentpreparations;Clinicaltrial.gov identifier:NCT01788709.
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