Impact of Bowel Preparation Type on Colonoscopy Quality and Adenoma Detection: A Comparative Study

Background Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Colonoscopy is the gold standard for CRC screening, but its effectiveness depends on bowel preparation quality. This study compares polyethylene glycol (PEG)-based MoviPrep (Norgine Limited, Hengoed, UK) and sodium picosulfate-based Picolax (Ferring GmbH, Kiel, Germany) in terms of bowel cleansing quality, caecal and ileal intubation rates, and adenoma detection rate (ADR). Methods This retrospective observational study analysed 6,921 colonoscopies performed at University Hospital Crosshouse between June 2020 and June 2023. Bowel preparation quality was assessed using the modified Ottawa Bowel Preparation Scale, categorised as Excellent, Good, Fair, or Inadequate. ADR was determined by histologically confirmed adenomas. Statistical comparisons between the two groups were performed using chi-square tests. Results MoviPrep was used in 6,219 (89.9%) of cases, while Picolax was used in 702 (10.1%) cases. MoviPrep was associated with a lower inadequate preparation rate (343 (5.5%) vs. 63 (9.0%)), a higher caecal intubation rate (3,675 (59.1%) vs. 307 (43.7%)) and ileal intubation rate (1,119 (18.0%) vs. 81 (11.5%)), and a higher ADR (2,295 (36.9%) vs. 167 (23.8%)). Conclusion MoviPrep demonstrated superior bowel cleansing, higher completion rates, and greater adenoma detection, supporting its use as a preferred bowel preparation method for colonoscopy in clinical practice.