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

Alexandros Ioannou; Georgios Axiaris; Panagiotis Baxevanis; Evgenia Papathanasiou; Mary Tzakri; Charalampos Koumentakis; Pavlos Pardalis; Emmanouil Pantelakis; Larisa Vasilieva; Georgios Leonidakis; Evanthia Zampeli; Spyridon Michopoulos

Authors Alexandros Ioannou, Georgios Axiaris, Panagiotis Baxevanis, Evgenia Papathanasiou, Mary Tzakri, Charalampos Koumentakis, Pavlos Pardalis, Emmanouil Pantelakis, Larisa Vasilieva, Georgios Leonidakis, Evanthia Zampeli, Spyridon Michopoulos.

Abstract

Background Bowel cleansing is an important factor for the quality of colonoscopy. We aimed to evaluate the efficacy of split-dose oral sulfate salts on bowel preparation and to determine parameters influencing the quality of bowel cleaning.

Method Consecutive adults who completed their preparation for colonoscopy with a regimen of sulfate salts were enrolled.

Results Of the 446 patients, 11 were excluded from the analysis. Among the 435 patients, 257 (59.1%) were female, mean age was 62.0±11.6 years and median body mass index (BMI) 26.1 kg/m2 (interquartile range [IQR] 23.8-29.4). Indications for colonoscopy were screening 155 (35.6%), surveillance 102 (23.5%), or other 178 (40.9%). The median time between the end of second dose of the preparation regimen and colonoscopy initiation was 5:15 h (IQR 4:30-6:00, min: 2:20, max: 12:20). Minor adverse events were reported in 62 (14.3%) patients. BBPS=9 was observed in 279 (64.14%) patients. Segmental BBPS=3 was achieved in 387 (88.97%), 346 (79.54%) and 289 (66.44%) patients (P<0.001) in the descending, transverse and ascending colon, respectively. Multivariate analysis revealed that BMI (odds ratio [OR] 1.05, 95% confidence interval [CI] 1-1.1) and time between the end of the second laxative dose and colonoscopy initiation (OR 1.25, 95%CI 1.08-1.45) were associated with poorer bowel
preparation.

Conclusions A split dose of oral sulfate salts is an efficacious and well tolerated regimen. Obesity and a longer time interval between the end of the second dose and colonoscopy initiation negatively influence bowel cleanliness.

Keywords Colonoscopy, bowel preparation, oral triphosphate

Ann Gastroenterol 2024; 37 (2): 172-178