Efficacy and tolerability of Moviprep compared to Colonlytely in patients undergoing colonoscopy
in a Day-Endoscopy Unit
Introduction: Colonlytely (PEG with electrolyte lavage) taken in large volume (3-4 litres) may induce
bloating and nausea, resulting in inadequate bowel preparation. Moviprep consisting of 2 litre PEG
plus ascorbic acid lavage may provide a more tolerable alternative.
Aim: to compare efficacy and tolerability of Moviprep and Colonlytely in a day-endoscopy unit.
Materials and Methods: 80 adult patients (mean age 53.8 years (range 24 to 69)were randomised
to receive either Moviprep: 2 litre PEG + ASC (Macrogol 3350 + Sodium ascorbate + Ascorbic acid +
Sodium Sulfate + Electrolytes) or Colonlytely: 4 litre PEG + Electrolytes (Sodium Sulfate + Macrogel
3350 + Sodium Bicarbonate + Sodium Chloride + Potassium Chloride) preparation according to
packet instructions. All patients were required to take the entire preparation on the day before
their morning procedures. Colonoscopic examinations were performed by 2 consultant
Gastroenterologists who were blinded to the type of bowel preparation. Patients completed a
questionnaire to assess tolerability (-nausea, vomiting, headache, abdominal pain, bloating, thirst
and dizziness). Bowel cleansing efficacy was scored using the Boston Bowel Preparation Scale
(BBPS)1 by one blinded observer. Total and segmental (-right colon, transverse colon, left colon)
were recorded. The mean BBPS was compared using t-test, and each colon region "segment scores"
were compared using Fisher's exact test with statistical significance at p<0.05.
Results:
Abdominal pain is significantly more common with Moviprep (p= 0.02). Although headache is
reported more frequently with Colonlytely than Moviprep, and thirst and abdominal bloating with
Moviprep, the differences are not statistically significant.
All patients completed colonoscopic examination to caecum or terminal ileum. The total BBPS for
colonlytely was 6.13 + 0.82 (SD) and Moviprep 5.70 + 0.91 (SD), the difference being statistically
significant (p=0.03). Although the mean scores are higher in the right colon and the transverse colon
for Colonlytely verses Moviprep, the difference is not statistically significant.
Conclusions:
In our small cohort: (1) Both Moviprep and Colonlytely were well tolerated with abdominal pain
being reported more frequently with Moviprep; (2) Colonlytely bowel preparation appeared to be
more efficacious than Moviprep using BBPS; (3) When segmental scores were analysed there was no
significant difference between the two groups, probably due to small sample size.
Reference
1.
Edwin J et al., Gastrointestinal Endoscopy 2009 March; 69 (3 Pt 2); 620-625.