Acute Gastropathy Associated with Bowel Preparation for Colonoscopy

Area of Science:

• Gastroenterology
• Endoscopy
• Pharmacology

Background:

• Low-volume bowel preparation agents improve patient compliance for colonoscopies.
• Gastric safety data for bowel preparation agents remain limited.
• Acute gastropathy associated with these agents requires thorough evaluation.

Purpose of the Study:

• To evaluate and compare the acute gastropathy associated with two bowel preparation agents: 1 L polyethylene glycol with ascorbic acid (1 L PEG/Asc) and oral sulfate tablets (OST).

Main Methods:

• A retrospective study comparing healthy subjects undergoing esophagogastroduodenoscopy (EGD) and colonoscopy.
• Evaluation of patient characteristics, bowel preparation success, acute gastropathy, and polyp/adenoma detection rates for 1 L PEG/Asc and OST groups.

Main Results:

• Both OST and 1 L PEG/Asc demonstrated similar bowel cleansing success rates.
• OST group showed significantly higher polyp and adenoma detection rates (p<0.001 and p=0.013).
• OST group exhibited significantly higher incidence of acute gastric mucosal lesions, including erosions and erythema (all p<0.001), and higher Lanza scores (1.3 vs 0.4, p<0.001).

Conclusions:

• Oral sulfate tablets (OST) are significantly associated with acute gastropathy compared to 1 L PEG/Asc.
• Physicians should carefully consider OST use for patients undergoing simultaneous EGD and colonoscopy screening due to increased gastric risks.