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World J Gastrointest Endosc. Jul 16, 2010; 2(7): 263-267
Published online Jul 16, 2010. doi: 10.4253/wjge.v2.i7.263
Lubiprostone used with polyethylene glycol in diabetic patients enhances colonoscopy preparation quality
Erika Grigg, Moonkyung C Schubert, Joshua Hall, Fadi Rahhal, Dimple Raina, Subbaramiah Sridhar, Sherman M Chamberlain
Erika Grigg, Moonkyung C Schubert, Joshua Hall, Fadi Rahhal, Dimple Raina, Subbaramiah Sridhar, Sherman M Chamberlain, Section of Gastroenterology and Hepatology, Medical College of Georgia, Augusta, GA 30912, United States
Author contributions: Grigg E enrolled patients, interpreted data and wrote the manuscript; Chamberlain SM wrote the grant to fund research and obtained IRB approval, enrolled a majority of patients and wrote the manuscript; Hall J enrolled patients; Rahhal F and Raina D helped in the grant writing to fund research and to obtain IRB approval; Schubert MC helped enroll patients and helped in the writing of the manuscript; and Sridhar S helped enroll patients.
Supported by Sucampo Pharmaceuticals, Inc., Bethesda, Maryland and Takeda Pharmaceuticals America, Inc., Deerfield, Illinois
Correspondence to: Sherman M Chamberlain, MD, FACP, AGAF, FACG, Section of Gastroenterology and Hepatology, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, United States. schamberlain@mcg.edu
Telephone: +1-706-7212238 Fax: +1-706-7210331
Received: May 12, 2010
Revised: June 22, 2010
Accepted: June 29, 2010
Published online: July 16, 2010
Abstract

AIM: To assess the additive effect of lubiprostone on the quality of colon preparation in diabetics given single-dosed polyethylene glycol electrolyte (PEG) for colonoscopy.

METHODS: This was an investigator-initiated, single-center, single-blinded prospective trial comparing the efficacy of L + PEG to PEG alone on colon preparation quality in diabetics undergoing screening colonoscopy. The study was approved by our institution’s IRB. The PEG was given as a single-dose to address patient-compliance concerns voiced by our IRB with split-dosing. All patients received only clear liquids the day prior to colonoscopy. Experimental group (Grp L) received PEG + 1 dose L 2 h prior to and 2 h after PEG completion. Control group (Grp C) received only PEG the evening prior to the colonoscopy. Patients were randomly assigned to one of the 2 groups. The endoscopist was blinded to which colon prep was given and all colonoscopies were complete. Upon colonoscopy completion, the endoscopist rated the colon prep-quality by a validated 5-point Likert scale (1-excellent to 5-inadequate).

RESULTS: Sixty patients were enrolled in the study; 30 Grp L and 30 Grp C. Overall, patients were excluded due to study non-completion in 12 (41%) Grp L and 5 (17%) Grp C, P = 0.04. Average colon preparation score Grp L = 2.47 and Grp C = 3.00, P = 0.09. Although this was not statistically significant, there was a trend towards improved colon prep in Grp L. Statistical significance may have been achieved if completion rates had been similar between both study groups.

CONCLUSION: Use of 2-L capsules with PEG resulted in a trend towards improved colon prep over PEG alone in diabetic patients when given as a single-dose regimen.

Keywords: Lubiprostone; Polyethylene glycol; Diabetes; Colonoscopy; colon preparation