Comparison of 1-L PEG-Asc with linaclotide versus sennoside for colon cleaning in constipated patients Poster Award Young Award

Background: Adjunctive laxative agents can reduce the volume of polyethylene glycol plus ascorbic acid (PEG-Asc) and increase patient tolerability. We hypothesized that addition of linaclotide to 1-L PEG-Asc would yield to better results than sennoside in constipated patients. Methods: This was a questionnaire-based retrospective study using inverse propensity of treatment weighting (IPTW) analysis. Among 1234 outpatients who underwent colonoscopy, constipated patients diagnosed according to Rome IV criteria were enrolled. Patients received linaclotide 500 μg (L group) or sennoside 24 mg (S group) prior to PEG-Asc. Results: 347 patients were classified into L group (n=73) and S group (n=275). Inadequate bowel preparation rate was significantly lower in L group than in S group (10% vs 20%, p=0.04) and adenoma detection rate was significantly higher in L group than in S group (63% vs 46%, p=0.01). There was no significant difference between 2 groups with respect to tolerability. The univariate and multivariate analysis revealed that linaclotide significantly reduced the risk of IBP (OR=0.42; OR=0.36, respectively). This risk reduction in the IBP by linaclotide remained robust after IPTW (OR=0.37). Conclusion: Linaclotide prior to 1-L PEG-Asc regimen significantly increased efficacy of bowel preparation compared to sennoside without reducing tolerability in constipated patients.