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Mentholyptus Drops Improve the Palatability and Bowel Cleansing Effect of PEG-Electrolyte Solution in Colonoscopy Preparation: A Randomized Controlled Trial: Presidential Poster

2012; Lippincott Williams & Wilkins; Volume: 107; Linguagem: Inglês

10.14309/00000434-201210001-01809

1572-0241

Mustapha El-Halabi, Carla Abou Fadel, Ala I. Sharara,

Colorectal Cancer Screening and Detection

Purpose: Current colonoscopy preparation regimens require the use of large volume of iso-osmotic PEG-electrolyte (PEG-E) solution for adequate cleansing and are often poorly tolerated by patients. The aim of this study was to assess the efficacy of mentholyptus drops in improving the palatability and tolerability of PEG-electrolyte solution used in bowel cleansing for colonoscopy. Methods: Randomized controlled trial including patients undergoing elective colonoscopy at the American University of Beirut Medical Center. Patients were excluded if they had active IBD, any contraindication to elective colonoscopy, or had a colonoscopy in the past 5 years. Patients were randomized to receive a 4L split-dose PEG-electrolyte solution (2L on 2 consecutive days) with or without mentholyptus sugar-free drops (Halls®, Cadbury Adams, New Jersey, USA). All patients were evaluated for tolerability of the preparation with palatability of the solution as a primary outcome. Palatability was assessed on a linear scale of 1 to 5 (1 = disgusting and 5 = tasty). The quality of the preparation, the remaining unconsumed volume of PEG-E and side effects were secondary outcomes. The endoscopist was blinded to the assignment arm. Clinicaltrials.gov identifier: NCT01541683. Results: 99 patients completed the study with 50 patients in the control arm and 49 patients in the mentholyptus drops arm (intervention arm). Patients in the intervention arm had a significantly higher palatability score than controls (mean palatability score 3.9±0.7 vs. 2.8±1.2 respectively; p<0.001). Quality of colonic preparation was also significantly better in the intervention arm (good or excellent preparation in 91.8% vs. 82% of controls; p=0.018). Side effects were not different between the 2 groups, except for nausea (24.5% of patients in the intervention arm vs. 44% of controls; p=0.04). 92% of patients in the mentholyptus drops arm vs. 80% of controls were willing to take the same preparation again in the future if necessary. The remaining unconsumed volume of PEG-E was significantly larger in patients with unacceptable (poor/fair) preparations than in those with acceptable preparations (good/excellent) (mean volume 361 ± 637 mL vs. 59 ± 165 mL respectively; p<0.001). Remaining unconsumed volume was the single variable associated with a poorer preparation on logistic regression with a p-value of 0.018 and an expected decrease of 20% in the odds of having an acceptable preparation (good/excellent) for every 100 mL of unconsumed PEG-E solution [OR=0.998 (95%CI: 0.996-1.0)]. Conclusion: Sugar-free mentholyptus drops are a safe and effective addition to split-dose PEG-electrolyte solution resulting in improved tolerability and bowel cleansing effect.