The leading causes of refractory peptic ulcers are Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs. Additionally, insufficient treatment for the suppression of gastric acid, smoking, alcohol consumption, and concomitant diseases can hinder recovery. Treatment includes the eradication of H. pylori, discontinuation of the causative agent, and appropriate suppression of gastric acid. Even after improvement of symptoms, sufficient proton pump inhibitor maintenance is necessary for 8 to 12 weeks. To increase the success rate of H. pylori eradication, it is essential to accurately determine the initial infection and for patients where treatment has failed due to antibiotic resistance, the success rate of treatment can be increased through sensitivity testing. Sometimes, evaluation for rare causes, such as Zollinger–Ellison syndrome, may be necessary, and follow-up gastroscopy must be performed to exclude the possibility of malignancy.

The leading causes of refractory peptic ulcers are Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs. Additionally, insufficient treatment for the suppression of gastric acid, smoking, alcohol consumption, and concomitant diseases can hinder recovery. Treatment includes the eradication of H. pylori, discontinuation of the causative agent, and appropriate suppression of gastric acid. Even after improvement of symptoms, sufficient proton pump inhibitor maintenance is necessary for 8 to 12 weeks. To increase the success rate of H. pylori eradication, it is essential to accurately determine the initial infection and for patients where treatment has failed due to antibiotic resistance, the success rate of treatment can be increased through sensitivity testing. Sometimes, evaluation for rare causes, such as Zollinger–Ellison syndrome, may be necessary, and follow-up gastroscopy must be performed to exclude the possibility of malignancy.

The leading causes of refractory peptic ulcers are Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs. Additionally, insufficient treatment for the suppression of gastric acid, smoking, alcohol consumption, and concomitant diseases can hinder recovery. Treatment includes the eradication of H. pylori, discontinuation of the causative agent, and appropriate suppression of gastric acid. Even after improvement of symptoms, sufficient proton pump inhibitor maintenance is necessary for 8 to 12 weeks. To increase the success rate of H. pylori eradication, it is essential to accurately determine the initial infection and for patients where treatment has failed due to antibiotic resistance, the success rate of treatment can be increased through sensitivity testing. Sometimes, evaluation for rare causes, such as Zollinger–Ellison syndrome, may be necessary, and follow-up gastroscopy must be performed to exclude the possibility of malignancy.

The leading causes of refractory peptic ulcers are Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs. Additionally, insufficient treatment for the suppression of gastric acid, smoking, alcohol consumption, and concomitant diseases can hinder recovery. Treatment includes the eradication of H. pylori, discontinuation of the causative agent, and appropriate suppression of gastric acid. Even after improvement of symptoms, sufficient proton pump inhibitor maintenance is necessary for 8 to 12 weeks. To increase the success rate of H. pylori eradication, it is essential to accurately determine the initial infection and for patients where treatment has failed due to antibiotic resistance, the success rate of treatment can be increased through sensitivity testing. Sometimes, evaluation for rare causes, such as Zollinger–Ellison syndrome, may be necessary, and follow-up gastroscopy must be performed to exclude the possibility of malignancy.

The leading causes of refractory peptic ulcers are Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs. Additionally, insufficient treatment for the suppression of gastric acid, smoking, alcohol consumption, and concomitant diseases can hinder recovery. Treatment includes the eradication of H. pylori, discontinuation of the causative agent, and appropriate suppression of gastric acid. Even after improvement of symptoms, sufficient proton pump inhibitor maintenance is necessary for 8 to 12 weeks. To increase the success rate of H. pylori eradication, it is essential to accurately determine the initial infection and for patients where treatment has failed due to antibiotic resistance, the success rate of treatment can be increased through sensitivity testing. Sometimes, evaluation for rare causes, such as Zollinger–Ellison syndrome, may be necessary, and follow-up gastroscopy must be performed to exclude the possibility of malignancy.

Background/Aims: The use of 1-L polyethylene glycol with ascorbate (PEG/Asc) and oral sulfate tablets (OST) as low-volume bowel preparation agents has gradually increased. However, these agents may induce acute gastropathy during bowel preparation, particularly in elderly populations. This study aimed to compare the incidence of acute gastropathy of 1-L PEG/Asc and OST according to age, as well as efficacy and safety. Methods: This retrospective study included patients who underwent esophagogastroduodenoscopy (EGD) and colonoscopy for screening on the same day and underwent bowel preparation using OST or 1-L PEG/Asc. We collected EGD findings related to acute gastropathy, bowel-cleansing score using the Boston Bowel Preparation Scale (BBPS), polyp or adenoma detection rate (ADR), and laboratory parameters. Results: Of 4,711 patients, 1,758, 2,241, and 712 were in the younger (18–49 years), middle-aged (50–64 years), and older (≥65 years) groups, respectively. In all age groups, the OST group had higher rates of acute gastropathy than the 1-L PEG/Asc group. The younger-, middle-, and older-aged groups had OST and 1-L PEG/Asc usage rates of 42.9% and 11.6%, 41.2% and 16.0%, and 41.5% and 16.4%, respectively. Notably, in the younger group, the total BBPS and ADR scores were significantly higher in the OST group than in the 1-L PEG/Asc group; however, these did not differ in the other age groups. Conclusions Acute gastropathy was more strongly associated with OST than with 1-L PEG/Asc in all age groups. Therefore, physicians should consider acute gastropathy associated with low-volume agents in all age groups when performing bowel preparation.

Background/Aims: The use of 1-L polyethylene glycol with ascorbate (PEG/Asc) and oral sulfate tablets (OST) as low-volume bowel preparation agents has gradually increased. However, these agents may induce acute gastropathy during bowel preparation, particularly in elderly populations. This study aimed to compare the incidence of acute gastropathy of 1-L PEG/Asc and OST according to age, as well as efficacy and safety. Methods: This retrospective study included patients who underwent esophagogastroduodenoscopy (EGD) and colonoscopy for screening on the same day and underwent bowel preparation using OST or 1-L PEG/Asc. We collected EGD findings related to acute gastropathy, bowel-cleansing score using the Boston Bowel Preparation Scale (BBPS), polyp or adenoma detection rate (ADR), and laboratory parameters. Results: Of 4,711 patients, 1,758, 2,241, and 712 were in the younger (18–49 years), middle-aged (50–64 years), and older (≥65 years) groups, respectively. In all age groups, the OST group had higher rates of acute gastropathy than the 1-L PEG/Asc group. The younger-, middle-, and older-aged groups had OST and 1-L PEG/Asc usage rates of 42.9% and 11.6%, 41.2% and 16.0%, and 41.5% and 16.4%, respectively. Notably, in the younger group, the total BBPS and ADR scores were significantly higher in the OST group than in the 1-L PEG/Asc group; however, these did not differ in the other age groups. Conclusions Acute gastropathy was more strongly associated with OST than with 1-L PEG/Asc in all age groups. Therefore, physicians should consider acute gastropathy associated with low-volume agents in all age groups when performing bowel preparation.

Background/Aims: The use of 1-L polyethylene glycol with ascorbate (PEG/Asc) and oral sulfate tablets (OST) as low-volume bowel preparation agents has gradually increased. However, these agents may induce acute gastropathy during bowel preparation, particularly in elderly populations. This study aimed to compare the incidence of acute gastropathy of 1-L PEG/Asc and OST according to age, as well as efficacy and safety. Methods: This retrospective study included patients who underwent esophagogastroduodenoscopy (EGD) and colonoscopy for screening on the same day and underwent bowel preparation using OST or 1-L PEG/Asc. We collected EGD findings related to acute gastropathy, bowel-cleansing score using the Boston Bowel Preparation Scale (BBPS), polyp or adenoma detection rate (ADR), and laboratory parameters. Results: Of 4,711 patients, 1,758, 2,241, and 712 were in the younger (18–49 years), middle-aged (50–64 years), and older (≥65 years) groups, respectively. In all age groups, the OST group had higher rates of acute gastropathy than the 1-L PEG/Asc group. The younger-, middle-, and older-aged groups had OST and 1-L PEG/Asc usage rates of 42.9% and 11.6%, 41.2% and 16.0%, and 41.5% and 16.4%, respectively. Notably, in the younger group, the total BBPS and ADR scores were significantly higher in the OST group than in the 1-L PEG/Asc group; however, these did not differ in the other age groups. Conclusions Acute gastropathy was more strongly associated with OST than with 1-L PEG/Asc in all age groups. Therefore, physicians should consider acute gastropathy associated with low-volume agents in all age groups when performing bowel preparation.

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.

Background/Aims: The use of 1-L polyethylene glycol with ascorbate (PEG/Asc) and oral sulfate tablets (OST) as low-volume bowel preparation agents has gradually increased. However, these agents may induce acute gastropathy during bowel preparation, particularly in elderly populations. This study aimed to compare the incidence of acute gastropathy of 1-L PEG/Asc and OST according to age, as well as efficacy and safety. Methods: This retrospective study included patients who underwent esophagogastroduodenoscopy (EGD) and colonoscopy for screening on the same day and underwent bowel preparation using OST or 1-L PEG/Asc. We collected EGD findings related to acute gastropathy, bowel-cleansing score using the Boston Bowel Preparation Scale (BBPS), polyp or adenoma detection rate (ADR), and laboratory parameters. Results: Of 4,711 patients, 1,758, 2,241, and 712 were in the younger (18–49 years), middle-aged (50–64 years), and older (≥65 years) groups, respectively. In all age groups, the OST group had higher rates of acute gastropathy than the 1-L PEG/Asc group. The younger-, middle-, and older-aged groups had OST and 1-L PEG/Asc usage rates of 42.9% and 11.6%, 41.2% and 16.0%, and 41.5% and 16.4%, respectively. Notably, in the younger group, the total BBPS and ADR scores were significantly higher in the OST group than in the 1-L PEG/Asc group; however, these did not differ in the other age groups. Conclusions Acute gastropathy was more strongly associated with OST than with 1-L PEG/Asc in all age groups. Therefore, physicians should consider acute gastropathy associated with low-volume agents in all age groups when performing bowel preparation.