Oral Sulfate Solution and 2-Liter Polyethylene Glycol-Ascorbic Acid Are Both Safe and Effective in Older Patients
Douglas K. Rex, MD, MASGE, reviewing Nam SJ, et al. J Gastroenterol Hepatol 2021 Sep 25.
In a trial of 199 patients aged 65 to 80 years, standard oral sulfate solution (OSS) was compared with 2-L polyethylene glycol with ascorbic acid (PEG-Asc) for bowel preparation. Adequate preparation with OSS (89.5%) was noninferior to 2-L PEG-Asc (93.6%). Vomiting (11.6% vs 2.1%) and thirst (24.2% vs 11.7%) were more common with OSS than 2-L PEG-Asc. The adenoma detection rate was higher with OSS than 2-L PEG-Asc (68.4% vs 54.3%; not significant). Overall patient satisfaction between the preparations was similar, whereas palatability was ranked better for 2-L PEG-Asc.
COMMENTBowel preparation studies in specific populations, such as older patients or patients with constipation, are of interest because they address specific, clinically important questions. With regard to older patients, there is generally a concern of increased risk associated with hyperosmotic preparations. These data suggest that OSS and 2-L PEG-Asc have comparable efficacy and safety profiles, though OSS was associated with more vomiting and lower palatability scores.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Nam SJ, Park SC, Lee SJ, et al. Randomized trial of oral sulfate solution versus polyethylene glycol-ascorbic acid for bowel cleansing in elderly people. J Gastroenterol Hepatol 2021 Sep 25. (Epub ahead of print) (https://doi.org/10.1111/jgh.15696)
