Background: Oral sulfate tablets (OSTs) are bowel preparation agents that combine oral sulfate solution and simethicone. This study compared the efficacy, tolerability, and safety of OST compared to 2 L-polyethylene glycol plus ascorbic acid (2 L-PEG/ASC). Methods: This prospective, randomized, controlled, single-blinded, multicenter, noninferiority trial enrolled 211 healthy adults who underwent colonoscopy between May 2020 and September 2022 at 13 university hospitals. The bowel cleansing rate was assessed using the Boston Bowel Preparation Scale (BBPS) and Harefield Cleansing Scale (HCS), and the preparation agents were administered in split regimens. Results: The total BBPS score (8.2 ± 1.5 vs. 7.8 ± 1.4, p = 0.040) and the high-quality bowel cleansing rates in the right colon (73.2% vs. 50.5), transverse colon (80.6% vs. 68.0%), and left colon (81.5% vs. 67.0%) on the BBPS were significantly higher in the OST group than in the 2 L-PEG/ASC group. However, the rates of successful cleansing according to BBPS (90.7% vs. 91.2%) and HCS (96.3% vs. 94.2%) did not significantly differ between the two groups.The taste, ease, and amount of consumption of the preparation agent; and willingness to repeat colonoscopy with the same agent (89.8% vs. 78.6%, P = 0.026) were significantly better in the OST group compared to the 2 L-PEG/ASC group. Adverse events and clinically significant laboratory changes were not significantly different between the two groups. Conclusion The OST was not inferior to 2 L-PEG/ASC in terms of bowel cleansing efficacy and showed better tolerability when used for bowel preparation for colonoscopy.

Background: Oral sulfate tablets (OSTs) are bowel preparation agents that combine oral sulfate solution and simethicone. This study compared the efficacy, tolerability, and safety of OST compared to 2 L-polyethylene glycol plus ascorbic acid (2 L-PEG/ASC). Methods: This prospective, randomized, controlled, single-blinded, multicenter, noninferiority trial enrolled 211 healthy adults who underwent colonoscopy between May 2020 and September 2022 at 13 university hospitals. The bowel cleansing rate was assessed using the Boston Bowel Preparation Scale (BBPS) and Harefield Cleansing Scale (HCS), and the preparation agents were administered in split regimens. Results: The total BBPS score (8.2 ± 1.5 vs. 7.8 ± 1.4, p = 0.040) and the high-quality bowel cleansing rates in the right colon (73.2% vs. 50.5), transverse colon (80.6% vs. 68.0%), and left colon (81.5% vs. 67.0%) on the BBPS were significantly higher in the OST group than in the 2 L-PEG/ASC group. However, the rates of successful cleansing according to BBPS (90.7% vs. 91.2%) and HCS (96.3% vs. 94.2%) did not significantly differ between the two groups.The taste, ease, and amount of consumption of the preparation agent; and willingness to repeat colonoscopy with the same agent (89.8% vs. 78.6%, P = 0.026) were significantly better in the OST group compared to the 2 L-PEG/ASC group. Adverse events and clinically significant laboratory changes were not significantly different between the two groups. Conclusion The OST was not inferior to 2 L-PEG/ASC in terms of bowel cleansing efficacy and showed better tolerability when used for bowel preparation for colonoscopy.

Background: Oral sulfate tablets (OSTs) are bowel preparation agents that combine oral sulfate solution and simethicone. This study compared the efficacy, tolerability, and safety of OST compared to 2 L-polyethylene glycol plus ascorbic acid (2 L-PEG/ASC). Methods: This prospective, randomized, controlled, single-blinded, multicenter, noninferiority trial enrolled 211 healthy adults who underwent colonoscopy between May 2020 and September 2022 at 13 university hospitals. The bowel cleansing rate was assessed using the Boston Bowel Preparation Scale (BBPS) and Harefield Cleansing Scale (HCS), and the preparation agents were administered in split regimens. Results: The total BBPS score (8.2 ± 1.5 vs. 7.8 ± 1.4, p = 0.040) and the high-quality bowel cleansing rates in the right colon (73.2% vs. 50.5), transverse colon (80.6% vs. 68.0%), and left colon (81.5% vs. 67.0%) on the BBPS were significantly higher in the OST group than in the 2 L-PEG/ASC group. However, the rates of successful cleansing according to BBPS (90.7% vs. 91.2%) and HCS (96.3% vs. 94.2%) did not significantly differ between the two groups.The taste, ease, and amount of consumption of the preparation agent; and willingness to repeat colonoscopy with the same agent (89.8% vs. 78.6%, P = 0.026) were significantly better in the OST group compared to the 2 L-PEG/ASC group. Adverse events and clinically significant laboratory changes were not significantly different between the two groups. Conclusion The OST was not inferior to 2 L-PEG/ASC in terms of bowel cleansing efficacy and showed better tolerability when used for bowel preparation for colonoscopy.

Background: Oral sulfate tablets (OSTs) are bowel preparation agents that combine oral sulfate solution and simethicone. This study compared the efficacy, tolerability, and safety of OST compared to 2 L-polyethylene glycol plus ascorbic acid (2 L-PEG/ASC). Methods: This prospective, randomized, controlled, single-blinded, multicenter, noninferiority trial enrolled 211 healthy adults who underwent colonoscopy between May 2020 and September 2022 at 13 university hospitals. The bowel cleansing rate was assessed using the Boston Bowel Preparation Scale (BBPS) and Harefield Cleansing Scale (HCS), and the preparation agents were administered in split regimens. Results: The total BBPS score (8.2 ± 1.5 vs. 7.8 ± 1.4, p = 0.040) and the high-quality bowel cleansing rates in the right colon (73.2% vs. 50.5), transverse colon (80.6% vs. 68.0%), and left colon (81.5% vs. 67.0%) on the BBPS were significantly higher in the OST group than in the 2 L-PEG/ASC group. However, the rates of successful cleansing according to BBPS (90.7% vs. 91.2%) and HCS (96.3% vs. 94.2%) did not significantly differ between the two groups.The taste, ease, and amount of consumption of the preparation agent; and willingness to repeat colonoscopy with the same agent (89.8% vs. 78.6%, P = 0.026) were significantly better in the OST group compared to the 2 L-PEG/ASC group. Adverse events and clinically significant laboratory changes were not significantly different between the two groups. Conclusion The OST was not inferior to 2 L-PEG/ASC in terms of bowel cleansing efficacy and showed better tolerability when used for bowel preparation for colonoscopy.

Background/Aims: Combination of midazolam and opioids is used widely for endoscopic sedation. Compared with meperidine, fentanyl is reportedly associated with rapid recovery, turnover rate of endoscopy room, and quality of endoscopy. We compared fentanyl with meperidine when combined with midazolam for sedative colonoscopy. Methods: A retrospective, cross-sectional, 1:2 matching study was conducted. Induction and recovery time were compared as the primary outcomes. Moreover, cecal intubation time, withdrawal time, total procedure time of colonoscopy, paradoxical reaction, adenoma detection rate, and adverse effect of midazolam or opioids were assessed as the secondary outcomes. Results: A total of 129 subjects (43 fentanyl vs. 86 meperidine) were included in the analysis. The fentanyl group showed significantly more rapid induction time (4.5±2.7 min vs. 7.5±4.7 min, p<0.001), but longer recovery time (59.5±25.6 min vs. 50.3±10.9 min, p=0.030) than the meperidine group. In multivariate analysis, the induction time of the fentanyl group was 3.40 min faster (p<0.001), but the recovery time was 6.38 min longer (p=0.046) than that of the meperidine group. There was no difference in withdrawal time and adenoma detection rate between the two groups. Conclusions The fentanyl group had more rapid sedation induction time but longer recovery time than the meperidine group.

Background/Aims: The quality of bowel preparation is one of the quality indicators for colonoscopy. The aim of this study was to compare the efficacy of oral sulfate solution (OSS) and polyethylene glycol plus ascorbic acid (PEG-AA) for bowel preparation. Methods: The study involved 167 patients who underwent diagnostic colonoscopies. Inadequate bowel preparation was defined as any score of ≤1 in each colon section based on the Boston Bowel Preparation Scale. Multivariate logistic regression was used to compare the efficacy of OSS and PEG-AA. Subgroup analyses were performed based on patient characteristics. Results: Overall, 106 (63.5%) patients received OSS, and 61 (36.5%) patients received PEG-AA. The rate of inadequate bowel preparation was 12.3% in patients receiving OSS and 32.8% in patients receiving PEG-AA (p=0.001). OSS (odds ratio [OR] = 0.26; p=0.003) and morning examination (OR=0.11; p=0.038) were significantly associated with efficient bowel preparation. The efficacy of OSS compared with PEG-AA was only significant in patients ≥50 years of age vs. <50 years of age (OR=0.13; p=0.001 vs. OR=0.96; p=0.959) and female vs. male patients (OR=0.06; p=0.002 vs. OR=0.58; p=0.339). Conclusions OSS was significantly more efficient for bowel preparation than PEG-AA, especially in patients ≥50 years of age and female patients. Morning examination led to a good quality of bowel preparation, irrespective of the preparation regimen.

Background/Aims: Dietary fiber intake is considered a protective factor for diverticular disease such as diverticulitis. However, evidence for an inverse connection between dietary fiber consumption and asymptomatic colonic diverticulosis is lacking. Specifically, few studies have investigated this subject in Asians with different presentations of diverticulosis. Therefore, we assessed the protective effects of a vegetarian diet for asymptomatic colonic diverticulosis in Buddhist monks who are obligatory vegetarians for spiritual reasons compared with the general population. Methods: A retrospective, cross-sectional, case-control study was conducted in age- and sex-matched Buddhist monks and the general population who underwent colonoscopy for screening at a Korean health promotion center from August 2005 to June 2018. We compared the prevalence of asymptomatic diverticulosis between the 2 groups using a self-administered questionnaire. Results: In this study, a total of 1,316 individuals were included (Buddhist monks of 658 and general population of 658) with a mean age of 52.6±9.5 years. The prevalence of asymptomatic diverticulosis in Buddhist monks was lower compared with the general population (6.7% [44/658] vs. 10.8% [71/658], P=0.008). Buddhist monks had a higher rate of high body mass index (BMI) and metabolic syndrome. By a multivariate regression analysis model, a nonvegetarian diet (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.21–2.72, P=0.004), old age (OR, 4.53; 95% CI, 1.36–15.12; P=0.014), male sex (OR, 1.91; 95% CI, 1.28–2.85; P=0.002), and a high BMI (OR, 1.50; 95% CI, 1.01–2.23; P=0.047) were independent predictors of asymptomatic diverticulosis. Moreover, a nonvegetarian diet was associated with both right-sided and left-sided diverticulosis. Conclusions A nonvegetarian diet may increase a risk of asymptomatic colonic diverticulosis in Asians.

BACKGROUND/AIMS: Recent Korean studies performed over the past few decades have shown diminishing efficacy and unacceptability of clarithromycin-based triple therapy as first-line eradication therapy for Helicobacter pylori infection, based on evidence of a declining eradication rate. Triple therapy continues to be used as first-line eradication therapy despite concerns regarding high clarithromycin resistance among Koreans. Patient compliance and acid suppression are important factors associated with the H. pylori eradication rate. We investigated whether regular administration of a proton pump inhibitor (PPI) 30 minutes before a meal can improve the eradication rate. MATERIALS AND METHODS: We retrospectively analyzed the data of 316 patients who were treated with first-line triple therapy (PPI, amoxicillin, and clarithromycin) for H. pylori infection between January 2012 and September 2017. Patients were divided into 2 groups based on the time of administration of the PPI (group A: before a meal, group B: after a meal). The urea breath test was performed 4~6 weeks after eradication of infection. RESULTS: Notably, 249 patients (78.8%, 249/316) showed successful eradication. The eradication rates in groups A and B were 87.5% (49/56 patients) and 76.9% (200/260 patients), respectively. We observed that regular administration of PPI before meals improved the eradication rate (P=0.079). CONCLUSIONS: We observed that although clarithromycin-based triple therapy was associated with an overall eradication rate <80%, regular PPI administration before meals improved the eradication rate. Regular PPI administration before meals and effective education to improve patient compliance could improve the eradication rate through maximal acid suppression.
Amoxicillin ; Breath Tests ; Clarithromycin ; Education ; Helicobacter pylori ; Helicobacter ; Humans ; Meals ; Patient Compliance ; Proton Pump Inhibitors ; Proton Pumps ; Protons ; Retrospective Studies ; Urea

BACKGROUND: Although lower urinary tract symptoms (LUTS) show a higher prevalence with age, few studies have reported the trend of these examination tools including uroflowmetry, urodynamic study and cystoscopy. METHODS: We evaluated the trend of performance of uroflowmetry, urodynamic study and cystoscopy by using National Health Insurance Data from 2010 to 2015. Primary outcome findings included cumulative number of patients per year, cumulative age-standardized patient rate per year and per age group, and correlation between the number of patients per year and the percentage of population per year in each age group. RESULTS: The overall trend for frequency of uroflowmetry and cystoscopy showed an increasing pattern (P < 0.001, respectively) while the trend for frequency of urodynamic study showed a decreasing pattern (P < 0.001). After age standardization, the overall trend showed similar results. Correlation between the number of patients per year and the percentage of population per year showed a positive correlation in the 50s age group and the above 70s age group (P = 0.003 and < 0.01, respectively) on uroflowmetry and in the above 70s age group (P < 0.01) on cystoscopy. Urodynamic study showed negative correlations in the 50s age group and the above 60s age group (P = 0.001 and 0.01, respectively). CONCLUSION: National trend for frequency of uroflowmetry, urodynamic study and cystoscopy showed a different trend. The increasing trend of uroflowmetry and cystoscopy was related with growth of the aged population. However, urodynamic study showed a decreasing trend regardless of the age group.
Cystoscopy* ; Humans ; Korea* ; Lower Urinary Tract Symptoms ; National Health Programs ; Prevalence ; Urodynamics*

BACKGROUND/AIMS: Gallbladder polyps (GBP) are a common clinical finding and may possess malignant potential. We conducted this study to determine whether visceral obesity is a risk factor for GBP. METHODS: We retrospectively reviewed records of subjects who received both ultrasonography and computed tomography with measurements of the areas of visceral adipose tissue and total adipose tissue (TAT) on the same day as health checkups. RESULTS: Ninety-three of 1,615 subjects (5.8%) had GBP and were compared with 186 age- and sex-matched controls. VAT (odds ratio [OR], 2.941; 95% confidence interval [CI], 1.325 to 6.529; p=0.008 for the highest quartile vs the lowest quartile) and TAT (OR, 3.568; 95% CI, 1.625 to 7.833; p=0.002 for the highest quartile vs the lowest quartile) were independent risk factors together with hypertension (OR, 2.512; 95% CI, 1.381 to 4.569; p=0.003), diabetes mellitus (OR, 2.942; 95% CI, 1.061 to 8.158; p=0.038), hepatitis B virus positivity (OR, 3.548; 95% CI, 1.295 to 9.716; p=0.014), and a higher level of total cholesterol (OR, 2.232; 95% CI, 1.043 to 4.778; p=0.039 for <200 mg/dL vs > or =240 mg/dL). Body mass index and waist circumference were not meaningful variables. CONCLUSIONS: Visceral obesity measured by VAT and TAT was associated with GBP irrespective of body mass index or waist circumference.
Adipose Tissue/ultrasonography ; Adult ; Case-Control Studies ; Cholesterol/blood ; Diabetes Complications ; Female ; Gallbladder Diseases/blood/epidemiology/*etiology ; Hepatitis B/complications ; Humans ; Hypertension/complications ; Intra-Abdominal Fat/ultrasonography ; Male ; Middle Aged ; Obesity, Abdominal/blood/*complications/ultrasonography ; Odds Ratio ; Polyps/blood/epidemiology/*etiology ; Prevalence ; Retrospective Studies ; Risk Factors