Efficacy and safety of a New D-sorbitol, Ascorbic Acid, and Picosulfate Bowel Cleansing Solution for colonoscopy: A prospective, multicenter, randomized study

Abstract

Background and aims: A low-volume, fast-acting bowel-cleansing agent may allow for a more convenient single-dose regimen, thereby improving patient adherence and comfort. This study aimed to evaluate the efficacy, safety, and acceptability of a novel bowel preparation solution containing D-sorbitol, ascorbic acid, and picosulfate (DAP). Methods: In this prospective, multicenter, randomized trial conducted at five Korean tertiary hospitals, patients undergoing colonoscopy received either 0.46-L DAP (same-day dosing) or 2-L polyethylene glycol plus ascorbic acid (PEG+Asc; split-dose). Bowel cleansing was assessed using the Harefield Cleansing Scale (HCS) by independent blinded raters, safety, and patient acceptability were evaluated RESULTS: A total of 243 patients (mean age 50.6 years; 39.6 % male) were enrolled, with 122 receiving DAP. Rates of successful bowel cleansing were similar between groups (DAP: 96.8 % vs. PEG+Asc: 96.7 %; p = 1.000). No significant differences were observed in clinical or laboratory safety parameters. The proportion of patients reporting difficulty ingesting the solution was significantly lower with DAP (22.1 % vs. 81.0 %; p < 0.01), and satisfaction scores were notably higher (8.71 vs. 6.22; p < 0.001). Conclusion: DAP-based bowel cleansing reduces the volume of solution required without compromising efficacy or safety, allowing for single-dose bowel preparation. This solution is more acceptable to patients, potentially improving adherence with bowel cleansing protocols and leading to a more effective colonoscopy. (c) 2025 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.