Impact of Bowel Preparation Type on Colonoscopy Quality and Adenoma Detection: A Comparative Study

TL;DR

This study compares two bowel prep solutions for colonoscopies and finds one to be more effective in improving colonoscopy quality and detecting cancerous growths.

Contribution

The study provides empirical evidence comparing PEG-based MoviPrep and sodium picosulfate-based Picolax for colonoscopy outcomes.

Findings

MoviPrep had a lower inadequate preparation rate (5.5%) compared to Picolax (9.0%).

MoviPrep showed higher caecal and ileal intubation rates than Picolax.

Adenoma detection rate was significantly higher with MoviPrep (36.9%) than with Picolax (23.8%).

Abstract

Background

Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Colonoscopy is the gold standard for CRC screening, but its effectiveness depends on bowel preparation quality. This study compares polyethylene glycol (PEG)-based MoviPrep (Norgine Limited, Hengoed, UK) and sodium picosulfate-based Picolax (Ferring GmbH, Kiel, Germany) in terms of bowel cleansing quality, caecal and ileal intubation rates, and adenoma detection rate (ADR).

Methods

This retrospective observational study analysed 6,921 colonoscopies performed at University Hospital Crosshouse between June 2020 and June 2023. Bowel preparation quality was assessed using the modified Ottawa Bowel Preparation Scale, categorised as Excellent, Good, Fair, or Inadequate. ADR was determined by histologically confirmed adenomas. Statistical comparisons between the two groups were performed using chi-square tests.

Results

MoviPrep was used in 6,219 (89.9%) of cases, while Picolax was used in 702 (10.1%) cases. MoviPrep was associated with a lower inadequate preparation rate (343 (5.5%) vs. 63 (9.0%)), a higher caecal intubation rate (3,675 (59.1%) vs. 307 (43.7%)) and ileal intubation rate (1,119 (18.0%) vs. 81 (11.5%)), and a higher ADR (2,295 (36.9%) vs. 167 (23.8%)).

Conclusion

MoviPrep demonstrated superior bowel cleansing, higher completion rates, and greater adenoma detection, supporting its use as a preferred bowel preparation method for colonoscopy in clinical practice.