A real-world single-center study on the effects of low-volume polyethylene glycol electrolyte solution and rhubarb for colonoscopy preparation: quality, tolerance, and experience
- 1Department of Gastroenterology, People's Hospital of Kaizhou District , , China
Abstract
Background: Low-volume polyethylene glycol electrolyte solution (PEG-ELS) combined with adjunctive laxatives may reduce oral fluid burden without compromising bowel cleansing quality. Evidence regarding rhubarb combined with low-volume PEG-ELS remains limited.
Methods: This retrospective single-center cohort included 257 patients undergoing elective colonoscopy from June 2023 to June 2024. Patients received low-volume PEG-ELS plus rhubarb (n = 131) or conventional 3-L PEG-ELS (n = 126). Primary outcomes were adequate bowel preparation rate and total Boston Bowel Preparation Scale (BBPS) score. Secondary outcomes included defoaming score, bubble-clearance time, insertion and withdrawal times, defecation timing, lesion detection, gastrointestinal adverse reactions, patient experience, and safety. Multivariable analyses adjusted for age, sex, body mass index, and constipation history. Propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and an exploratory constipation subgroup analysis were performed. Prespecified non-inferiority margins were −10% for adequate preparation rate and −1 point for total BBPS score.
Results: Adequate preparation occurred in 94.66% (124/131) of the combination group and 89.68% (113/126) of controls, with a difference of 4.98% (95%CI: −1.54% to 11.50%), meeting the prespecified non-inferiority criterion. Total BBPS score also met the non-inferiority criterion (adjusted β = 0.17, 95%CI: −0.05 to 0.40, P = 0.136). The combination group had a lower defoaming score (adjusted β = −0.20, P = 0.020) and shorter bubble-clearance time (18.72 ± 7.64 vs. 27.35 ± 9.12 s, P < 0.001), whereas insertion time was similar (6.84 ± 2.16 vs. 7.13 ± 2.38 min, P = 0.304). Time to first defecation and total bowel evacuation were shorter, and overall gastrointestinal adverse reactions were less frequent (all P < 0.001). Satisfaction and willingness to reuse the regimen were higher (both P = 0.010). Lesion detection rates did not differ. PSM and IPTW confirmed the main findings. Among 39 patients with constipation, defecation-related times were shorter with the combination regimen, whereas BBPS, preparation adequacy, defoaming score, and insertion time were similar. No serious bowel preparation-related adverse events were documented.
Conclusions: Low-volume PEG-ELS plus rhubarb maintained bowel cleansing quality while improving defoaming, evacuation efficiency, gastrointestinal tolerance, and patient experience. Improved defoaming did not significantly shorten insertion time. Findings in patients with constipation require prospective randomized confirmation.
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BibTeX
@article{tan2026realworld,
title = {{A real-world single-center study on the effects of low-volume polyethylene glycol electrolyte solution and rhubarb for colonoscopy preparation: quality, tolerance, and experience}},
author = {Caiwen Tan},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1922646},
url = {https://europepmc.org/article/PMC/PMC13730830},
note = {CC BY},
}
RIS
TY - JOUR
TI - A real-world single-center study on the effects of low-volume polyethylene glycol electrolyte solution and rhubarb for colonoscopy preparation: quality, tolerance, and experience
AU - Caiwen Tan
PY - 2026
DA - 2026/10/21
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1922646
UR - https://europepmc.org/article/PMC/PMC13730830
AB - Background: Low-volume polyethylene glycol electrolyte solution (PEG-ELS) combined with adjunctive laxatives may reduce oral fluid burden without compromising bowel cleansing quality. Evidence regarding rhubarb combined with low-volume PEG-ELS remains limited. Methods: This retrospective single-center cohort included 257 patients undergoing elective colonoscopy from June 2023 to June 2024. Patients received low-volume PEG-ELS plus rhubarb (n = 131) or conventional 3-L PEG-ELS (n = 126). Primary outcomes were adequate bowel preparation rate and total Boston Bowel Preparation Scale (BBPS) score. Secondary outcomes included defoaming score, bubble-clearance time, insertion and withdrawal times, defecation timing, lesion detection, gastrointestinal adverse reactions, patient experience, and safety. Multivariable analyses adjusted for age, sex, body mass index, and constipation history. Propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and an exploratory constipation subgroup analysis were performed. Prespecified non-inferiority margins were −10% for adequate preparation rate and −1 point for total BBPS score. Results: Adequate preparation occurred in 94.66% (124/131) of the combination group and 89.68% (113/126) of controls, with a difference of 4.98% (95%CI: −1.54% to 11.50%), meeting the prespecified non-inferiority criterion. Total BBPS score also met the non-inferiority criterion (adjusted β = 0.17, 95%CI: −0.05 to 0.40, P = 0.136). The combination group had a lower defoaming score (adjusted β = −0.20, P = 0.020) and shorter bubble-clearance time (18.72 ± 7.64 vs. 27.35 ± 9.12 s, P < 0.001), whereas insertion time was similar (6.84 ± 2.16 vs. 7.13 ± 2.38 min, P = 0.304). Time to first defecation and total bowel evacuation were shorter, and overall gastrointestinal adverse reactions were less frequent (all P < 0.001). Satisfaction and willingness to reuse the regimen were higher (both P = 0.010). Lesion detection rates did not differ. PSM and IPTW confirmed the main findings. Among 39 patients with constipation, defecation-related times were shorter with the combination regimen, whereas BBPS, preparation adequacy, defoaming score, and insertion time were similar. No serious bowel preparation-related adverse events were documented. Conclusions: Low-volume PEG-ELS plus rhubarb maintained bowel cleansing quality while improving defoaming, evacuation efficiency, gastrointestinal tolerance, and patient experience. Improved defoaming did not significantly shorten insertion time. Findings in patients with constipation require prospective randomized confirmation.
SN - 2296-858X
ER -