Hospitalized patients often face significant difficulties with standard bowel cleansing protocols. However, a recent multicenter randomized trial has provided new insights into using **low-volume bowel preparation** for these individuals. This study compared the efficacy of 1-liter (1L), 2-liter (2L), and 4-liter (4L) polyethylene glycol (PEG) regimens. Because poor visualization frequently complicates inpatient colonoscopies, finding a more tolerable solution is vital.
Benefits of Low-volume Bowel Preparation
Researchers found that the 1L PEG-ascorbate regimen achieved similar rates of adequate cleansing compared to higher volumes. Specifically, adequate cleansing occurred in 82% of the 1L group. In contrast, the 2L and 4L groups achieved rates of 78% and 78.5%, respectively. Furthermore, the 1L protocol yielded significantly higher rates of high-quality cleansing. This was especially evident in the right colon, which is often difficult to clear.
Safety and Patient Satisfaction
Most patients reported a high willingness to repeat the 1L regimen despite experiencing some thirst and vomiting. Consequently, clinicians should consider this very low-volume option to improve patient compliance. While the study excluded patients with active bleeding, the results remain highly applicable to elective procedures. Overall, the findings suggest that reducing fluid intake does not compromise clinical outcomes for stable inpatients.
Frequently Asked Questions
Q1: Is the 1-liter PEG regimen as effective as the traditional 4-liter dose for hospitalized patients?
Yes, the trial demonstrated that the 1L PEG-ascorbate regimen provides similar rates of adequate bowel cleansing while offering superior high-quality cleansing results compared to the 4L dose.
Q2: What were the most common side effects reported with the 1L bowel prep?
Patients in the 1L group reported more frequent instances of thirst and vomiting. However, they still expressed a significantly higher willingness to repeat the procedure compared to those using higher-volume regimens.
References
- Frazzoni L et al. Low-Volume Polyethylene Glycol for Bowel Preparation in Hospitalized Adults : A Multicenter Randomized Trial. Ann Intern Med. 2026 May 05. doi: 10.7326/ANNALS-25-05005. PMID: 42081822.
- Xiao K et al. Low-Volume Bowel Prep Easier, as Effective as Standard Prep in Hospitalized Patients. ACG Annual Meeting. 2024.
- Agrawal R et al. Predictors of poor bowel preparations and colonoscopy cancellations in inpatient colonoscopies. Transl Gastroenterol Hepatol. 2022.