S2042 Meta-Analysis and Systematic Reviews: Bowel Preparation With Polyethylene Glycol vs Non-Polyethylene Glycol in IBD Patients
Bibliographic record
Abstract
Introduction: Inadequate bowel preparation increases the chances of missing small or large polyps, decreases cecal intubation rate, prolongs colonoscopy time, and may lead to cancellation or rescheduling of the procedure. Inflammatory bowel disease (IBD) patients require colonoscopy from the beginning to aid in diagnosis, monitor disease activity, evaluate treatment response and allow frequent surveillance for colon cancer. IBD patients experiences the highest embarrassment, pain and lowest satisfaction score. Most guidelines recommend the use of polyethylene glycol (PEG) solutions over non-PEG in IBD patients which limits the overall acceptance of non-PEG solutions. However, the use of non-PEG solutions as per disease severity is now being considered. Therefore, the primary aim of this systematic review and meta-analysis is to assess if non-PEG solutions are equally efficacious as PEG solutions in IBD patients. Methods: Multiple databases were searched through June 2024 for studies comparing PEG vs non-PEG in IBD patients. The primary outcome of our study was successful bowel preparation if Boston Bowel Preparation Scale (BBPS) of ≥6, Ottawa Bowel Preparation Score of ≤5, Harefield Cleansing Scale [HCS] ≥A or B. Secondary outcome was willingness to repeat. Meta-analysis was performed to determine the pooled risk ratio (RR) using random effects model. Results: Four randomized controlled trials involving a total of 479 participants were included in the final analysis. 254 participants received PEG whereas 225 participants received non-PEG. Random-effects meta-analysis of 4 RCTs showed no significant difference in bowel preparation success between PEG and non-PEG regimens (RR = 1.01, 95% CI 0.88–1.16, I² = 0%). Three RCTs (n = 384) found no significant difference in willingness to repeat bowel preparation between PEG and non-PEG regimens (RR = 0.92, 95% CI 0.78–1.08, I² = 0%). Conclusion: Our findings suggest that there is no significant difference in bowel preparation success (RR = 1.01) or willingness to repeat (RR = 0.92) between PEG and non-PEG regimens in IBD patients. The findings suggest that non-PEG regimens may be considered suitable alternatives to PEG, especially in patients who struggle with PEG due to volume or taste. The low heterogeneity in both primary and secondary outcomes strengthens our confidence in the findings. However, given the limited number of studies and small sample sizes, further large-scale trials are needed to confirm the safety and efficacy of non-PEG preparations in different IBD subgroups.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.035 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.040 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".