Evaluation of bowel preparation regimens for colonoscopy including a novel low volume regimen (Plenvu): CLEANSE study

BMJ Open Gastroenterol. 2023 Mar;10(1):e001070. doi: 10.1136/bmjgast-2022-001070.

Abstract

Background: Poor bowel preparation is the leading cause of failed colonoscopies and increases costs significantly. Several, split preparation, 2 day regimens are available and recently, Plenvu, a low-volume preparation which can be given on 1 day has been introduced.

Aims: Assess efficacy and tolerability of commonly used purgative regimens including Plenvu.

Method: In this service evaluation, patients undergoing screening colonoscopy at St Mark's Hospital, London (February 2020-December 2021) were provided Plenvu (1 or 2 days), Moviprep (2 days) or Senna & Citramag (2 days).Boston Bowel Preparation Scale (BBPS) score, fluid volumes and procedure times were recorded. A patient experience questionnaire evaluated taste, volume acceptability, completion and side effects.

Results: 563 patients were invited to participate and 553 included: 218 Moviprep 2 days, 108 Senna & Citramag 2 days, 152 Plenvu 2 days and 75 Plenvu 1 day.BBPS scores were higher with Plenvu 1 and 2 days vs Senna & Citramag (p=0.003 and 0.002, respectively) and vs Moviprep (p=0.003 and 0.001, respectively). No other significant pairwise BBPS differences and no difference in preparation adequacy was seen between the groups.Patients rated taste as most pleasant with Senna & Citramag and this achieved significance versus Plenvu 1 day and 2 days (p=0.002 and p<0.001, respectively) and versus Moviprep (p=0.04).

Conclusion: BBPS score was higher for 1 day and 2 days Plenvu versus both Senna & Citramag and Moviprep. Taste was not highly rated for Plenvu but it appears to offer effective cleansing even when given as a same day preparation.

Keywords: colonoscopy; diagnostic and therapeutic endoscopy; endoscopy.

MeSH terms

  • Cathartics* / administration & dosage
  • Cathartics* / adverse effects
  • Cathartics* / therapeutic use
  • Colonoscopy* / methods
  • Humans
  • Polyethylene Glycols* / administration & dosage
  • Polyethylene Glycols* / adverse effects
  • Polyethylene Glycols* / therapeutic use
  • Senna Extract / administration & dosage
  • Senna Extract / adverse effects
  • Senna Extract / therapeutic use
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Cathartics
  • magnesium citrate
  • MoviPrep
  • Polyethylene Glycols
  • Senna Extract