BRIEF RESEARCH REPORT article
Front. Gastroenterol.
Sec. Therapy in Gastroenterology
Volume 4 - 2025 | doi: 10.3389/fgstr.2025.1630479
This article is part of the Research TopicAdvances in Inflammatory Bowel Disease: Treatment, Targets and TherapyView all 7 articles
Evaluating Bowel Preparation Tolerability in IBD: A Phase 3 Post-Hoc Comparison of Mannitol and PEG-ASC
Provisionally accepted
Gian Eugenio Tontini1,2*Alessandro Rimondi1,3
Flavio Caprioli1,2
Giovanni Aldinio1Luca Pastorelli4Franco Radaelli5Cristiano Spada6,7
MAURIZIO VECCHI1,2- 1Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy
- 2Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- 3Royal Free Unit for Endoscopy, Royal Free London NHS Foundation Trust, London, United Kingdom
- 4Department of Health Sciences, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- 5Gastroenterology Unit, Valduce Hospital, Como, Italy
- 6Digestive Endoscopy Unit, Poliambulanza Brescia Hospital, Brescia, Italy
- 7Digestive Endoscopy Unit, University Hospital Agostino Gemelli, Rome, Italy
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Bowel preparation is a significant challenge for patients undergoing colonoscopy, especially in Inflammatory Bowel Disease (IBD) patients. Oral mannitol (OM), an ultra-low-volume, single-dose osmotic laxative with a sweet taste, could improve patient tolerability. We performed a post-hoc analysis of the phase 3, multicentre, randomised, endoscopist-blinded SATISFACTION trial to compare same-day OM versus standard split-dose 2L polyethylene glycol plus ascorbate (PEG-ASC) for bowel preparation in IBD patients. Fifty-five IBD patients (24 OM, 31 PEG-ASC) were assessed for bowel cleansing efficacy, endoscopic outcomes, safety, and patient satisfaction. OM demonstrated superior tolerability, including ease of use (88% vs. 71%), taste satisfaction (75% vs. 6%), and willingness to reuse (96% vs. 71%). OM also reduced intake duration (32 vs. 107 minutes) and time to evacuation (57 vs. 91 minutes), with comparable efficacy, cleansing quality, and safety. In conclusion, same-day OM preparation enhances satisfaction and adherence in IBD patients, offering a safe, effective alternative to standard protocols.
Keywords: Bowel preparation, inflammatory bowel disease, Colonoscopy, oral mannitol, polyethylene glycol, Patient tolerability, ulcerative colitis, Crohn's disease
Received: 17 May 2025; Accepted: 30 Jul 2025.
Copyright: © 2025 Tontini, Rimondi, Caprioli, Aldinio, Pastorelli, Radaelli, Spada and VECCHI. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gian Eugenio Tontini, Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy
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