Taking Oral Sulfate Tablets with Simethicone for Bowel Preparation Leads to Higher Adenoma Detection Rate than Polyethylene Glycol: A Propensity Score Analysis

Background Efficient bowel preparation is essential for preventing colorectal cancer by improving endoscopic adenoma detection. Tablet for bowel preparation containing sulfate salts, OSTs (oral sulfate tablets), has been developed and it is gaining more popularity. However, its efficacy compared to...

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Bibliographic Details
Published in:Digestive diseases and sciences 2023-03, Vol.68 (3), p.867-876
Main Authors: Lee, Seung Eun, Oh, Dong Jun, Nam, Ji Hyung, Cho, Hyeki, Kim, Jae Hak, Lee, Jun Kyu, Lim, Yun Jeong, Koh, Moon Soo, Kim, Sang Hoon
Format: Article
Language:English
Subjects:
Adenoma
Adenoma - chemically induced
Adenoma - diagnosis
Adult
Aged
Biochemistry
Cancer
Cathartics - adverse effects
Colonoscopy
Colonoscopy - methods
Colorectal cancer
Comparative analysis
Data warehouses
Endoscopy
Gastroenterology
Hepatology
Humans
Medical colleges
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Oncology
Original Article
Patient compliance
Polyethylene glycol
Polyethylene Glycols - adverse effects
Prevention
Propensity Score
Retrospective Studies
Simethicone
Sulfates
Tablets
Transplant Surgery
Tumors
Warehouse stores
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Summary:Background Efficient bowel preparation is essential for preventing colorectal cancer by improving endoscopic adenoma detection. Tablet for bowel preparation containing sulfate salts, OSTs (oral sulfate tablets), has been developed and it is gaining more popularity. However, its efficacy compared to standard preparation agent, PEG-AA (polyethylene glycol), has not been well discovered. We assessed the efficacy of PEG and OSTs using a real-time clinical data warehouse (CDW) model. Methods We performed a propensity score-matched (PSM) analysis of consecutive adult patients undergoing colonoscopy who received PEG-AA or OSTs prior to colonoscopy at a tertiary academic hospital. The endoscopic records of 992 adult patients were retrospectively analyzed. The clinical data warehouse collected data including bowel preparation, insertion time, observation time, and the detection of polyps and adenomas. Multivariate regression analysis was performed to reveal the factors associated with endoscopic outcomes. Results Among 992 patients included in the study, 770 and 222 patients received PEG-AA and OSTs, respectively. Among the propensity score-matched population ( n  = 1897), OSTs resulted in better bowel cleansing quality (8.16 vs 7.84, p  = 0.014) and a higher adenoma detection rate (38.6% vs 27.1%, p  = 0.003). Using PEG-AA, older age, inadequate bowel preparation (BBPS score 
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-022-07611-8