# Effect of linaclotide combined with polyethylene glycol on bowel preparation before colonoscopy in patients with constipation

## TL;DR

This study compares linaclotide combined with low-volume PEG to standard PEG for bowel preparation in constipated patients undergoing colonoscopy.

## Contribution

The study introduces a four-day linaclotide regimen with low-volume PEG as a better-tolerated alternative for bowel preparation in constipated patients.

## Key findings

- The 4-day linaclotide + 2L PEG group showed better left colon cleansing than the 2-day linaclotide + 2L PEG group.
- Linaclotide groups reported fewer adverse symptoms and higher satisfaction compared to the standard 3L PEG group.
- No significant differences in overall bowel preparation scores or detection rates were found between groups.

## Abstract

Linaclotide, a promising medication for treating irritable bowel syndrome with predominant constipation, has the potential to enhance bowel preparation for colonoscopy. This study aims to evaluate the efficacy and tolerability of linaclotide combined with low-volume polyethylene glycol (PEG) in constipated patients.

In this randomized, single-blind controlled trial, 210 constipated patients were assigned to one of three groups: (1) 3 L PEG (standard regimen), (2) 2-day linaclotide + 2 L PEG (2D + 2 L PEG), or (3) 4-day linaclotide + 2 L PEG (4D + 2 L PEG). Bowel cleansing was assessed using the Boston Bowel Preparation Scale (BBPS). Adverse symptoms, detection rates of intestinal findings, patient satisfaction, and willingness to repeat the procedure were recorded.

No significant differences in overall BBPS scores or detection rates were observed among the three groups. However, the 4D + 2 L PEG group showed superior left colon cleansing compared to the 2D + 2 L PEG group. Both linaclotide groups experienced fewer adverse symptoms (bloating, nausea, and vomiting) and reported higher satisfaction than the 3 L PEG group.

A four-day regimen of oral linaclotide combined with 2 L PEG offers effective and well-tolerated bowel preparation with fewer adverse symptoms, making it a favorable option for constipated patients undergoing colonoscopy.

http://www.chictr.org.cn (registration no. ChiCTR2400083515).