Background: Colonoscopy is currently the standard method for diagnosis and treatment for a
number of colonic diseases. The patient needing colonoscopy has to undertake bowel
preparation before the investigation. This process is very important as it can determine
diagnostic accuracy and therapeutic success in the patients. Prucalopride is a substance that
helps stimulate colonic movement. This study aimed to assess the effectiveness of the
combination between prucalopride and polyethylene glycol solution (PEG-P) for bowel
preparation before colonoscopy relative to PEG alone.
Materials and Methods: This study used a prospective, randomized, double-blinded,
controlled design. Eighty six patients undergoing colonoscopy in Bhumibol Adulyadej
Hospital were enrolled in the study (44 in PEG arm vs 42 in PEG-P arm). The effectiveness
of the colonic bowel preparation was assessed using Boston Bowel Preparation Score
(BBPS), satisfaction, side effects and polyp detection rate also served as secondary outcomes.
Results: PEG-P significantly showed better bower preparation relative to PEG, as reflected
by the higher BBPS in all parts of colons: caecum (2.1 ± 0.6 vs 1.6 ± 0.7, p=0.002),
transverse colon (2.6 ± 0.7 vs 2.1 ± 0.6, p=0.001), sigmoid (2.8 ± 0.6 vs 2.4 ± 0.6, p=0.002)
and rectum (2.8 ± 0.6 vs 2.4 ± 0.6, p=0.002). Five out of forty two patients in the PEG-P arm
had nausea and three had vomiting. Two patients in the PEG arm group had nausea and none
had vomiting. The incidence of side effects in both arms did not show a statistically
significant difference. PEG-P arm showed higher polyp detection rate than the PEG arm
(59.5% vs 36.4%, p=0.032).
Conclusion: PEG-P showed many preferable outcomes over PEG. These include better
bowel cleansing and increasing the sensitivity of polyp detection with indifferent rate of side
effects. With these advantages, the quality of life and compliance of the patients can be
improved as repeated colonoscopy due to inadequate bowel preparation can be avoided.

Keywords: prucalopride, polyethylene glycol solution, colonoscopy, bowel preparation,
Boston bowel preparation score