Journal Article

1 versus 2 L PEG/Asc for bowel preparation in patients with hematochezia: a multicenter, prospective, randomized, non-inferiority study

Kim, Su Young, Lee, Sang Hoon, Lee, Jundeok, Kim, Hyunil, Park, Hong Jun, Kim, Hyun-Soo

2026

Overview

Comparing two bowel cleansing volumes for patients with hematochezia who need a colonoscopy Hematochezia, which means passing bright red blood from the bowel, is a common reason for people to seek medical care. When this happens, doctors usually recommend a colonoscopy to find the cause of bleeding and provide treatment. To perform a safe and accurate colonoscopy, the bowel must be properly cleaned. However, drinking large amounts of cleansing solution is often uncomfortable, especially for people who are already unwell. This study examined whether a smaller amount of bowel cleansing solution could work as well as a larger amount in patients with hematochezia. We compared two cleansing regimens: a 1-liter solution and a 2-liter solution. Our main goal was to learn whether the smaller amount would clean the bowel well enough for doctors to clearly see the inside of the colon. We also evaluated how patients felt while taking the solution and whether any side effects occurred. We conducted a randomized clinical study at two hospitals. Adults with hematochezia were assigned to drink either the 1-liter or the 2-liter solution before their colonoscopy. We measured bowel cleanliness, the ability of doctors to identify the bleeding source, patient comfort and willingness to repeat the same preparation, and any safety concerns. The study included 184 patients. Overall, the 1-liter solution cleaned the bowel just as well as the 2-liter solution. In some parts of the colon, especially the transverse and left segments, the 1-liter solution even performed slightly better. Both groups had similar success in identifying the source of bleeding, and no serious side effects were found. Many patients found the smaller-volume preparation easier and more comfortable to take. These results suggest that a 1-liter preparation is an effective and safe option for people with hematochezia who need a colonoscopy. A smaller amount may improve comfort without reducing the quality of the examination.

• Publisher: SAGE Publications,SAGE Publishing
• Subject: Original Research