Retrospective Analysis of Bowel Bubbles During Colonoscopy Following Bowel Preparation with Oral Sulfate Solution or 2 L Polyethylene Glycol-Electrolyte Solution with Ascorbic Acid.

INTRODUCTION

Bowel bubbles are one of the key factors influencing the quality of colonoscopy. We aimed to evaluate the density of luminal bubbles in colonoscopy and compared oral sulfate solution (OSS) with 2L polyethylene glycol and electrolyte solution with ascorbic acid (PEG) in a same-day preparation.

METHODS

This was a retrospective multicenter study. A total of 162 patients (45 OSS and 117 PEG) who underwent colonoscopy with bubble assessment between June and September 2024 were analyzed. The rate of bubbles by location and the risk factors for severe bubbles in the proximal colon were examined. Additionally, the comparisons of bubbles and polyp detection in OSS and PEG after propensity-score matching were performed using an original score named as bowel bubble score of colonoscopy (BBS-C; score 0: none-score 3: severe).

RESULTS

Among 162 cases, the rates of severe bubbles were 16.0% in the proximal colon and 9.9% in the distal colon (p = 0.098). In the multivariate analysis of risk factors for severe bubbles in the proximal colon, good preparation was positively associated with severe bubbles (OR: 4.878; 95% CI 1.33-20.0; p = 0.017), with poor preparation as the reference. After matching, the rates of severe bubbles in the proximal colon between the OSS and PEG groups were 11.1% vs. 6.7% (p = 0.470).

CONCLUSION

The rates of bubbles in each segment were examined by BBS-C, and good bowel preparation was a risk factor for proximal severe bubbles. There was no significant difference regarding severe bubbles between OSS and PEG.