Stefano Pontone, Rossella Palma, Cristina Panetta, Chiara Eberspacher, Rita Angelini, Daniele Pironi, Angelo Filippini, Paolo Pontone

The aim of our pilot study was to evaluate the impact of a new same-day, low dose, 1-liter polyethylene glycol-based (1L-PEG) bowel preparation on the diagnostic rating and tolerability of selected hospitalized patients with risk factors for inadequate bowel preparation. A single-center prospective pilot study was conducted with hospitalized patients scheduled for colonoscopy, presenting with clinical risk factors for poor bowel preparation, such as bleeding and/or subocclusive symptoms. All included patients were randomly divided in two groups, which received either a same-day 1L-PEG bowel preparation (Group A) or a split-dose 4L-PEG bowel preparation (Group B), and performed a colonoscopy within four hours of the last dose. Forty-four inpatients (male=27; mean age 63.5 years; age range=20-94) were enrolled between August 2015 and August 2016. Optimal bowel cleansing was reached in 63% and 56% (p=.64), of patients in Groups A and B respectively. The adenoma detection rate was 14% (Group A) and 19% (Group B) (p=.34). A valid diagnosis was reached in 38 of 44 patients (86%) (Group A=21; Group B=17) after a mean hospitalization of three days for Group A and six days for Group B (p=.04). Our data support that the schedule protocol proposed in this study enables a clear diagnosis in most of the inpatients facing a high risk for poor bowel preparation and no statistical differences are found between the two groups in terms of successful bowel cleansing achieved. Therefore, the same-day, low dose 1L-PEG bowel preparation could be introduced for selected inpatients.