AIM:To compare the quality and tolerance of esophag ogastroduodenoscopy(EGD)-assisted and conventional split-dose polyethylene glycol electrolyte solution for inpatient colonoscopy.METHODS:The study was a randomized controlled trial in hospitalized patients.Hospitalized patients undergoing colonoscopy the day following EGD for evaluation of gastrointestinal(GI) bleeding or other symptoms.Patients randomized to either EGD-assisted bowel prep [2 L polyethylene glycol(PEG) administered endoscopically into distal duodenum at time of EGD,plus 1 L PEG orally the following day] or conventional-PEG(2 L PEG orally the evening prior and 1 L PEG orally the following day).The main outcome measurements are bowel preparation quality and patient tolerance of bowel prep.RESULTS:Forty-two patients randomized to EGD-assisted bowel prep and 40 patients to conventional-PEG.Overall mean ± SD preparation quality was superior for EGD-PEG(4.1 ± 2.8) vs conventional-PEG(6.5 ± 3.1;P = 0.0005).Seventy-four percent of patients rated EGDPEG as easy or slightly difficult to tolerate compared to 46% for standard-PEG(P = 0.0133).Mean EGD-procedural time was greater for EGD-assisted subject(24 ± 10 min) compared to conventional-PEG prep subjects(15 ± 7 min;P < 0.0001).Conscious sedation requirements did not differ between groups.There were no significant prep-related adverse events in either group.CONCLUSION:In selected hospitalized patients,compared to a conventional split-dose regimen,use of EGD to administer the majority of PEG solution improves patient tolerance and quality of bowel preparation for colonoscopy. AIM: To compare the quality and tolerance of esophag ogastroduodenoscopy (EGD) -assisted and conventional split-dose polyethylene glycol electrolyte solution for inpatient colonoscopy. METHODS: The study was a randomized controlled trial in hospitalized patients. Hospitalized patients undergoing colonoscopy the day following EGD for evaluation of gastrointestinal (GI) bleeding or other symptoms. Patients randomized to either EGD-assisted bowel prep [2 L polyethylene glycol (PEG) administered endoscopically into distal duodenum at time of EGD, plus 1 L PEG orally the following day] or conventional PEG (2 L PEG orally the evening prior and 1 L PEG orally the following day). The main outcome measurements are bowel preparation quality and patient tolerance of bowel prep .RESULTS: Forty-two patients randomized to EGD-assisted bowel prep and 40 Patients to conventional-PEG.Overall mean ± SD preparation quality was superior for EGD-PEG (4.1 ± 2.8) vs conventional-PEG (6.5 ± 3.1; P = 0.0005) .Seventy-four pe rcent of patients rated EGDPEG as easy or slightly difficult to tolerate compared to 46% for standard-PEG (P = 0.0133) .Mean EGD-procedural time was greater for EGD-assisted subject (24 ± 10 min) compared to conventional-PEG prep subjects (15 ± 7 min; P <0.0001) .Conscious sedation requirements did not differ between groups. There were no significant prep-related adverse events in either group. CONCLUSION: In selected hospitalized patients, compared to a conventional split-dose regimen, use of EGD to administer the majority of PEG solution improves patient tolerance and quality of bowel preparation for colonoscopy.