PEG bowel preparations for colonoscopy mildly raise RGV
Bowel preparations with polyethylene glycol (PEG) slightly elevate residual gastric volume (RGV) but appear to have no clinical significance, according to a new study.
“Obstacles to high-volume bowel preparation by anaesthesia providers resulting from concerns over aspiration risk are common during colonoscopy,” researchers said.
To examine the RGV in colonoscopy after bowel preparations with 3-L PEG, the authors conducted prospective measurement of RGV in patients undergoing esophagogastroduodenoscopy (EGD) and morning colonoscopy with split-dose PEG preparation, patients undergoing EGD and afternoon colonoscopy with same-day PEG preparation, and patients undergoing EGD alone under moderate conscious sedation.
Consumption of clear liquids was permitted among colonoscopy patients until 2 hours before the procedure. Patients undergoing EGD alone were instructed not to eat or drink anything after midnight.
A total of 860 patients (n=330 in the split-dose preparation group; n=100 in the same-day preparation group; n=430 in the EGD-only group) were evaluated. Baseline demographics and disease/medication factors were similar.
Patients receiving the same-day preparation (35.4 mL or 0.56 mL/kg) had a significantly higher mean RGV than those receiving the split-dose preparation (28.5 mL or 0.45 mL/kg; p=0.023) and those undergoing EGD alone (22.8 mL or 0.36 mL/kg; p<0.0001)
Within the bowel-preparation groups, RGV was similar between patients with fasting times of 2 to 3 hours and those with fasting times >3 hours. All three groups had similar distribution shape and RGV range. There was no aspiration in any group.
These findings support the current fasting guidelines for colonoscopy, according to researchers.