Discussion
Adequate bowel prep, overweight, colonoscopic bowel preparation, constipation
ADVERSE REACTIONS, OBESE
This multicenter randomized controlled trial study confirmed that 3 L split-dose PEG regimen was superior to 2 L PEG regimen in colonoscopic bowel preparation in relatively high-BMI individuals (BMI ≥ 24 kg/mThe optimum dose of PEG for bowel preparation before colonoscopy remains a matter of debate. A meta-analysis [Adequate bowel prep is important, and RABP is recommended to be over 85% [Although, the 3L split-dose PEG regimen performed better than the 2 L PEG regimen, 81.2% of the rate of adequacy is not enough. Whether it is better to use a 4 L regimen or change the oral preparation than a 3L regimen is currently unknown. In one previous study [The adenoma-detection rate (ADR), a quality indicator for colonoscopy, was recommended in the guidelines to be ≥ 25% [Asians generally have a smaller build, and the BMI classifications are different in the east and west. According to the Chinese standard, individuals with a BMI (24-24.9kg/mConstipation was identified as a predictor of colonoscopy preparation failure in previous research, and individuals with constipation might need more PEG [This study had several strengths. First, it was a multicenter RCT using the block randomization method. Second, the endoscopists were blinded to the bowel preparation regimen of the patients, which reduced subjective bias. However, there were still some drawbacks, for example, recall bias and the small sample size of the obese subgroup. In addition, 50 patients were lost to follow-up, we could not obtain information on adverse reactions. Moreover, there were no control subjects with normal BMI, and our subjects are not that overweight (especially BMI in the 30+ range). At last, split-dose regimen was not taken in the 2L PEG group. This prospective study can provide evidence for colonoscopic bowel preparation in relatively high-BMI individuals.In conclusion, our multicenter randomized controlled trial study confirmed that 3 L split-dose PEG regimen was superior to 2 L PEG regimen in bowel cleansing before colonoscopy in people with BMI ≥ 24 kg/m