Endoscopists’ Perspectives on Polyethylene Glycol Electrolyte Lavage Solution vs. Sodium Picosulfate/Magnesium Citrate for Bowel Preparation Before Colonoscopy: A Qualitative Study
DOI:
https://doi.org/10.31351/vol35iss3pp19-28Keywords:
Bowel cleansing agents,, Colonoscopy, Endoscopists, Polyethylene glycol electrolyte solution(PEGELS), Sodium picosulphate\Magnesium citrate(SPMC)Abstract
Background: A successful colonoscopy depends on adequate bowel preparation. Even though there are several cleaning products and routines available, the best practices differ in real-world situations, and recommendations frequently lack context specificity. Objectives: This qualitative study aimed to understand endoscopists’ perspectives on bowel preparation for colonoscopy, focusing on the choice between polyethylene glycol electrolyte solution (PEGELS) and sodium picosulphate/magnesium citrate (SPMC), effectiveness evaluation, agent-related side effects, patients' tolerability, and preparation-related recommendations. Method: Fifteen endoscopists from two tertiary gastroenterology institutions in Iraq participated in semi-structured interviews. The six-phase framework developed by Braun and Clarke was followed when applying thematic analysis. Results: The findings showed that there were five main themes: (1) factors affecting selection decisions for bowel cleansing agents, (2) evaluating the effectiveness of bowel cleansing agents, (3) side effects of bowel cleansing agents, (4) factors affecting patient acceptance, and (5) preparation recommendations before a colonoscopy procedure. The study found no significant difference in effectiveness between SPMC and PEGELS, with SPMC preferred for taste and convenience, while comorbidity concerns were not consistently documented. Conclusion: The results highlight the possibility that patient compliance affected by agent taste and volume may be more important for effective colon cleansing than the agent selection. The majority of endoscopists supported split-dose regimens and dietary changes despite some variations in the number of restriction days and the use of adjuvant laxatives; however, there is still a glaring need for local guidelines.
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