• Hong Seok Choi, Chan Sup Shim, Gyu Won Kim, Jung Seok Kim, Sun-Young Lee, In-Kyung Sung, Hyung Seok Park, and Jeong Hwan Kim.
• 1Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea 2Department of Internal Medicine, Sahm Yook Hospital, Seoul, Korea.
• Dis. Colon Rectum. 2014 Oct 1; 57 (10): 1220-7.

BackgroundMany patients report discomfort because of the unpleasant taste of bowel preparation solutions.ObjectiveThis study aimed to determine whether adding orange juice to 2 L of polyethylene glycol plus ascorbic acid is effective for reducing patient discomfort and improving palatability during bowel preparation.DesignThis was a single-blinded, randomized controlled trial.SettingsThe study was conducted at a tertiary referral hospital and a generalized hospital.PatientsConsecutive outpatients and inpatients were randomly allocated to drink 2 L of polyethylene glycol-ascorbic acid or 2 L of polyethylene glycol-ascorbic acid with orange juice in a single dose or a split dose.Main Outcome MeasuresTolerability, palatability score, willingness, and related adverse events were investigated by questionnaires. Bowel cleansing was rated using the Aronchick scale. Each score was graded on a 5-point scale.ResultsA total of 107 patients, 53 in the orange juice group and 54 in the polyethylene glycol-ascorbic acid group who underwent elective colonoscopy were enrolled. The palatability score (mean ± SD) was higher in the orange juice group than in the control group (2.36 ± 0.76 vs 1.78 ± 0.88; p = 0.005). Nausea was less frequent in the orange juice group (26.4% vs 59.3%; p = 0.001). Total amount of bowel preparation ingested was not significantly different between the groups (p = 0.44). The bowel preparation score (mean ± SD) was not significantly different (1.49 ± 0.80 vs 1.43 ± 0.77; p = 0.94). Willingness to repeat the same process was higher in the orange juice group (90.4% vs 66.7%; p = 0.003).LimitationsThis study is limited because only ambulatory patients were enrolled.ConclusionsOrange juice intake before drinking 2 L of polyethylene glycol-ascorbic acid for colonoscopy can reduce patient discomfort, resulting in improved acceptability and patient compliance. This method is as effective for bowel cleansing as polyethylene glycol.

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