Evaluation of parameters influencing the quality of colon preparation with a split dose regimen of sulfate salts

Aims To evaluate the parameters which may influence bowel preparation in a split-dose regimen

Methods Consecutive adults who completed their preparation for colonoscopy with a combination of sodium sulfate anhydrous, magnesium sulfate heptahydrate and potassium sulfate. A questionnaire evaluated diet and laxative intake before the colonoscopy. Cleanliness was evaluated with the Boston Bowel Preparation Scale (BBPS, Optimal=9, Suboptimal=6-8).

Results 435 patients, 59.1% female. Mean age 61.9±11.6 years. Median BMI 26.1 kg/m²(IQR:23.8–29.4). Median liquid intake: 3lt(IQR:2–3.5). Median time between the end of second laxative dose and colonoscopy initiation was 5h:15min (IQR:4:30–6:00). Minor adverse events reported in 62(14.2%) patients. Cecum catheterization in 425(97.7%). BBPS=9 in 279(64.14%) patients. Segmental BBPS=3 was achieved in 387(88.97%), 346(79.54%) and 289(66.44%) patients (p<0.01) in the descending, transverse and ascending colon respectively. In multivariate analysis, BMI (OR=1.05,95%C.I:1–1.1) and time between the end of the 2nd laxative dose and colonoscopy initiation (OR=1.25, 95% C.I:1.08–1.45) were correlated with lower bowel preparation. Overall adenoma detection rate (ADR) was 48.7(95%C.I:43.9–53.5). Right colon ADR:34.9(95%C.I.:30.4-39.6). No difference in the ADR between optimal and suboptimal cleanliness.

Conclusions 1) Split dose of tri-sulfate salts is efficacious and well tolerated 2) A suboptimal cleanliness mainly in the ascending colon does not influence ADR 3) Obesity and time interval between the end of the 2nd dose and colonoscopy initiation negatively influence bowel cleanliness.

 

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Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publikationsverlauf

Artikel online veröffentlicht:
14. April 2023