Patient Characteristics Associated With Preference for 480-mL Oral Sodium Sulfate: A Prospective Clinical Study on Bowel Cleansing Efficacy and Taste Acceptability for Total Colonoscopy.
OSSs achieved high-quality bowel cleansing with a lower fluid intake, and taste acceptability was a key factor in patient preference, especially among elderly males.
Where it sits
this study against the rest of the glutathione (gsh) corpusSummary and findings
This study evaluated the efficacy and tolerability of oral sulfate solutions (OSSs) compared to polyethylene glycol plus ascorbate (PEG-ASC) in patients undergoing colonoscopy. Among 263 patients, 98% achieved satisfactory cleansing with a Boston Bowel Preparation Scale (BBPS) score of ≥6. The study identified factors associated with patient preference for OSS, including taste acceptability.
Abstract
Background and aims Oral sulfate solutions (OSSs) are used for low-volume bowel preparation but have a distinctive bitter taste. This study evaluated the efficacy and tolerability of OSSs compared with polyethylene glycol plus ascorbate (PEG-ASC) and identified patient factors associated with favorable acceptability. Methods In this prospective single-center study, patients undergoing colonoscopy using OSSs who had used PEG-ASC for a previous colonoscopy within 2 years were enrolled. Cleansing quality (Boston Bowel Preparation Scale [BBPS]), ingested volume, adverse events, patient preference, and taste acceptability were assessed. Outcomes were also compared between elderly (≥75 years) and non-elderly patients. Results Among 263 patients, 98% achieved satisfactory cleansing (BBPS ≥ 6). Overall, 54% preferred OSS for their next procedure. Multivariate analysis identified favorable taste acceptability as the strongest predictor of preference (odds ratio [OR], 4.88). Favorable taste acceptability tended to be associated with male sex (OR, 1.58; p = 0.09) and age ≥ 75 years (OR, 1.69; p = 0.07). Older male patients showed significantly higher favorable taste acceptability than younger female patients (63% vs. 40%; p = 0.03). Elderly patients had lower total fluid intake (p = 0.04) and fewer adverse events (p < 0.01), particularly nausea, while maintaining cleansing quality equivalent to non-elderly patients. Conclusions OSS provided high-quality cleansing with a reduced intake volume. Elderly patients tended to have favorable taste acceptability for OSS, and effective cleansing was achieved with even lower total fluid intake and fewer adverse events. OSS represents an advantageous bowel preparation option for the aging population. Trial registration UMIN-CTR: UMIN000052571.
Background
This study addresses the clinical question of bowel preparation efficacy and patient acceptability of oral sulfate solutions (OSSs) compared to traditional methods like polyethylene glycol plus ascorbate (PEG-ASC). Prior research indicated that OSSs could be effective but had a bitter taste that might affect patient compliance. Understanding patient preferences and factors influencing acceptability is crucial for improving bowel preparation protocols, especially in the elderly population.
Methods
This was a prospective single-center study involving patients who underwent colonoscopy using OSSs and had previously used PEG-ASC within the last 2 years. The study assessed cleansing quality using the Boston Bowel Preparation Scale (BBPS), ingested volume, adverse events, patient preference, and taste acceptability. The analysis included comparisons between elderly (≥75 years) and non-elderly patients.
Results
Among the 263 patients, 98% achieved satisfactory cleansing with a BBPS score of ≥6. Overall, 54% of patients preferred OSS for their next procedure. Multivariate analysis indicated that favorable taste acceptability was the strongest predictor of preference, with an odds ratio of 4.88. Additionally, older male patients had a significantly higher favorable taste acceptability compared to younger female patients (63% vs. 40%; p = 0.03). Elderly patients also had lower total fluid intake (p = 0.04) and fewer adverse events (p < 0.01).
Interpretation
The findings suggest that OSSs can provide effective bowel cleansing with a lower volume intake, particularly appealing to elderly patients. While the statistical significance of the results is notable, the clinical significance of the taste acceptability and its predictors may vary. The study's limitations, including its single-center design and potential biases, suggest caution in generalizing the results to broader populations.
Key findings
- 98% achieved satisfactory cleansing (BBPS ≥ 6) among 263 patients.
- 54% preferred OSS for their next procedure.
- Favorable taste acceptability was the strongest predictor of preference (OR, 4.88).
- Older male patients showed significantly higher favorable taste acceptability than younger female patients (63% vs. 40%; p = 0.03).
- Elderly patients had lower total fluid intake (p = 0.04) and fewer adverse events (p < 0.01).
Limitations
- single-center design may limit generalizability
- potential selection bias from patient preference
- reliance on subjective measures of taste acceptability
- no long-term follow-up reported