Same-Day vs. Split-Dose Bowel Preparation for Afternoon Colonoscopy

Same-day preparation produced better cleansing, with fewer adverse events and less disruption of daily activities.


Several studies have clearly shown that split-dosing bowel preparations (giving half the preparation the evening before colonoscopy and half on the morning of the procedure) is superior to day-before dosing with regard to both cleansing efficacy and tolerability (JW Gastroenterol Jun 24 2011). In other studies, same-day dosing has provided better cleansing compared with evening-before dosing for afternoon colonoscopy (JW Gastroenterol Dec 3 2010) and equivalent cleansing and better tolerability compared with split-dosing (JW Gastroenterol Oct 1 2010). To further explore the merits of this strategy, researchers in the U.K. conducted a nonrandomized, single-blind study of same-day versus split-dose bowel-cleansing regimens in 227 patients who underwent afternoon screening colonoscopy.

In the split-dose group, 95 consecutive patients, recruited during a 6-month period, were given three sachets of sodium picosulphate at noon and 5:00 PM the day before the procedure and at 8:00 AM the morning of the procedure. In the same-day group, 132 consecutive patients, recruited during the succeeding 6-month period, were given sodium picosulphate at 7:00 AM and 10:00 AM the morning of the procedure.

The same-day group achieved better-quality bowel preparation than the split-dose group (P=0.005) and experienced fewer adverse events (P=0.002) and less disruption of daily activities (P<0.001). In addition, patients strongly preferred the same-day regimen.


Citation(s):

Longcroft-Wheaton G and Bhandari P. Same-day bowel cleansing regimen is superior to a split-dose regimen over two days for afternoon colonoscopy: Results from a large prospective series. J Clin Gastroenterol 2012 Jan; 46:57.