Bowel Bubble Formation with Oral Sulfate Solution for Colonoscopy Bowel Preparation Using Same-Day and Split-Day...

Area of Science:

• Gastroenterology
• Endoscopy
• Clinical Research

Background:

• Bowel bubble formation during colonoscopy can compromise mucosal visualization and procedural efficiency.
• The clinical significance of severe bowel bubbles, particularly in the proximal colon, requires further characterization.
• Oral sulfate solution (OSS) is a common bowel preparation agent, with varying administration regimens.

Purpose of the Study:

• To evaluate the prevalence of severe bowel bubbles in the proximal colon.
• To assess the impact of severe bowel bubbles on colonoscopic quality, including procedure time and adenoma detection rates.
• To compare bubble formation between a same-day (SAR) and split-day (SPR) OSS regimen.

Main Methods:

• Retrospective analysis of 176 SAR and 51 SPR cases undergoing colonoscopy with OSS bowel preparation.
• Evaluation of severe proximal colon bubble prevalence and its correlation with cecal insertion time, total procedure time, and preparation-to-colonoscopy interval.
• Comparison of adenoma detection rates between cases with and without severe bubbles.

Main Results:

• Severe bowel bubbles occurred in 17.6% of cases in both SAR and SPR regimens.
• Cases with severe bubbles exhibited significantly longer cecal insertion times (9.0 vs 7.0 min) and total procedure times (24.0 vs 20.0 min).
• A longer preparation-to-colonoscopy interval was associated with increased severe bubble formation (p=0.041). Adenoma detection rates were similar (67.5% vs 73.2%).

Conclusions:

• Severe bowel bubble formation is associated with increased colonoscopy procedure times.
• Bubble prevalence was similar between same-day and split-day OSS regimens.
• Longer intervals between bowel preparation and colonoscopy may increase the likelihood of severe bubble formation.