Korean J Gastroenterol.  2024 Aug;84(2):82-89. 10.4166/kjg.2024.068.

Acute Gastropathy Associated with Bowel Preparation for Colonoscopy

• Park SB
• Lee M
• Kwak MS
• Cha JM

• KMID: 2558899
• DOI: http://doi.org/10.4166/kjg.2024.068

Abstract

Background/Aims
Utilization of low-volume preparation agents is crucial to improve patient willingness to undergo repeat colonoscopies. However, gastric safety data on preparation agents are limited. This study evaluated the acute gastropathy associated with bowel preparation agents.
Methods
This retrospective study enrolled healthy subjects who underwent both esophagogastroduodenoscopy and colonoscopy screening. Baseline patient characteristics, bowel preparation success, acute gastropathy, and polyp and adenoma detection rates were evaluated for 1 L polyethylene glycol with ascorbic acid (1 L PEG/Asc) and oral sulfate tablet (OST) groups.
Results
Comparison of the OST group (n=2,463) with the 1 L PEG/Asc group (n=2,060) revealed that the rates of successful cleansing and high-quality cleansing were similar between the two groups. Polyp and adenoma detection rates were significantly higher in the OST group than in the 1 L PEG/Asc group (p<0.001 and p=0.013), while the incidence of acute gastric mucosal lesion-like blood stain/clot, erosions at greater curvature side of antrum/body, multiple erosions, and overlying mucosal erythema or edema were all significantly higher in the OST group than in the 1 L PEG/Asc group (all p<0.001). Additionally, high and indeterminate probability scores of preparation agent-induced gastropathy (p=0.001) and mean Lanza scores were significantly higher in the OST group than in the 1 L PEG/Asc group (1.3 vs. 0.4, p<0.001).
Conclusions
Compared with 1 L PEG/Asc, OSTs were significantly associated with acute gastropathy during bowel preparation, thus requiring careful consideration from physicians for the simultaneous screening of EGD and colonoscopy.

Keyword

Cathartics; Colonoscopy; Gastropathy; Oral sulfate tablet; Polyethylene glycol

Figure

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  Fig. 1 Example of acute gastropathy associated with bowel preparation, such as acute gastric mucosal lesion-like blood clots (A) or superficial gastric ulceration (B).

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