{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:55:52Z","timestamp":1792032952825,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":77,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008321","name":"Pennsylvania State University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Linaclotide, a guanylyl cyclase\u2010C agonist, may enhance efficacy and tolerability when combined with polyethylene glycol (PEG) for bowel preparation. This meta\u2010analysis evaluated linaclotide plus PEG versus PEG alone for bowel preparation prior to colonoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Randomized controlled trials (RCTs) including adults undergoing colonoscopy that compared linaclotide plus PEG with PEG alone for bowel preparation were identified via database search up to March 2024. Statistical analysis was performed in RevMan Web using random\u2010effects models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven RCTs were analyzed. Adequate bowel preparation rate was comparable (risk ratio [RR] 1.01, 95% confidence interval [CI] 0.98\u20131.04; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200923%), as was cecal intubation rate (RR 1.01, 95% CI 1.00\u20131.01). Subgroup analyses showed that compared with 3\u2010L PEG alone, 2\u2010L PEG plus linaclotide was non\u2010inferior, while 3\u2010L PEG plus linaclotide was superior regarding bowel preparation adequacy (RR 1.11, 95% CI 1.01\u20131.23) and total Boston Bowel Preparation Scale (BBPS) score (mean difference 0.44, 95% CI 0.04\u20130.85). Right and left colon BBPS scores were also higher with linaclotide. Polyp detection rate improved significantly in the 3\u2010L PEG plus linaclotide subgroup (RR 1.78, 95% CI 1.32\u20132.40), whereas adenoma detection rate and withdrawal\u00a0time were comparable. Linaclotide reduced abdominal pain, bloating, nausea, and sleep disturbance, and increased willingness to repeat colonoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Linaclotide with PEG provides comparable overall bowel cleansing to PEG alone while reducing adverse events and improving patient acceptance. Importantly, 2\u2010L PEG plus linaclotide was non\u2010inferior compared with 3\u2010L PEG, whereas 3\u2010L PEG plus linaclotide showed superiority over 3\u2010L PEG alone, supporting its use in low\u2010volume bowel preparation strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.70008","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T10:14:58Z","timestamp":1758017698000},"page":"318-333","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and Safety of Linaclotide as an Adjunct to Polyethylene Glycol in Bowel Preparation: A Meta\u2010Analysis"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4010-7545","authenticated-orcid":false,"given":"Muhammad","family":"Shahzil","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Penn State Health Milton S. Hershey Medical Center, The Pennsylvania State University  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fariha","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Cooper University Hospital  Camden New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Akram","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Medicine King Edward Medical University  Lahore Punjab Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab","family":"Jamil","sequence":"additional","affiliation":[{"name":"Department of Medicine King Edward Medical University  Lahore Punjab Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talha","family":"Kashif","sequence":"additional","affiliation":[{"name":"Department of Medicine King Edward Medical University  Lahore Punjab Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4785-7922","authenticated-orcid":false,"given":"Muhammad Saad","family":"Faisal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Henry Ford Hospital  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha Bin","family":"Arif","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Sinai Hospital of Baltimore  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammad Javaid","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Henry Ford Hospital  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umer","family":"Farooq","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Saint Louis University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5546-9197","authenticated-orcid":false,"given":"Hassam","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology ECU Health  Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Levenick","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Penn State Health Milton S. Hershey Medical Center, The Pennsylvania State University  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Operative Pediatric Surgery","author":"Stauffer C. M.","year":"2025"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20138"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.418"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0959-0505"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2011.06795.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-313905"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.21037\/jgo-23-581"},{"key":"e_1_2_8_9_1","volume-title":"StatPearls","author":"Kalola U. 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