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Split-dosing of bowel preparations for colonoscopy was endorsed by the American College of Gastroenterology in 2009 and subsequently by other societies. Some resistance to split-dosing remains based on perceived inconvenience to patients and a risk for aspiration from fluid ingestion close to the time of colonoscopy. In two previous studies of same-day upper endoscopy and colonoscopy, findings demonstrated no significant increase in residual gastric volumes in patients with split-dosing compared with evening-before dosing, but these studies were not randomized.
In a single-center study, investigators randomly assigned 328 patients scheduled for simultaneous esophagogastroduodenoscopy and colonoscopy to split-dose or previous-day bowel prepar…