1-L Prep Boosts Quality, Not Adequacy - Summary - MDSpire

1-L Prep Boosts Quality, Not Adequacy

Randomized trial in hospitalized patients found improved high-quality bowel cleansing with 1-L regimen, though primary endpoint differences were not statistically significant

  • By

  • Andrea Surnit

  • May 5, 2026

  • 3 min

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Objective:

To compare the effectiveness of 1-L polyethylene glycol-ascorbate bowel preparation against 2-L and 4-L PEG-ascorbate specifically in hospitalized adults undergoing elective colonoscopy.

Key Findings:
  • Adequate cleansing rates were similar across groups: 82% (1 L), 78% (2 L), 79% (4 L).
  • High-quality cleansing occurred more often with 1-L regimen (47%) compared to 2-L (35%) and 4-L (37%).
  • Willingness to repeat preparation was highest in the 1-L group (84%).
  • Vomiting was more frequent with the 1-L regimen (15%) compared to 2-L (7%) and 4-L (11%).
  • Polyp detection rates were 31% (1 L and 4 L) and 23% (2 L).
Interpretation:

The 1-L PEG-ascorbate preparation resulted in higher quality bowel cleansing without compromising adequate cleansing rates, suggesting it may be a preferable option for hospitalized patients.

Limitations:
  • The study was underpowered due to not reaching the planned enrollment of 846 patients, which limits the reliability of the primary endpoint findings.
  • Findings for the primary endpoint should be interpreted cautiously due to the study's design limitations.
  • The trial excluded patients undergoing urgent colonoscopy or with severe conditions, which may limit the generalizability of the results to broader populations.
Conclusion:

In hospitalized adults undergoing elective colonoscopy, 1-L PEG-ascorbate yielded higher rates of high-quality cleansing with similar adequate cleansing rates and high willingness to repeat, though these findings should be interpreted in light of the study's limitations.

Original Source(s)

1-L Prep Boosts Quality, Not Adequacy

  • by Andrea Surnit

  • May 5, 2026

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