Increased Risk of Erosive Gastritis Using Oral Sulfate Tablet Bowel Preparation: A Retrospective Single-Center Cohort Study
Bibliographic record
Abstract
Background: In 2020, the Food and Drug Administration approved an oral sulfate tablet (OST) containing sodium sulfate, magnesium sulfate, and potassium chloride as a colonoscopy preparation that is more palatable and convenient than polyethylene glycol (PEG) with comparable efficacy. There is a precautionary warning regarding potential risk of mucosal ulcerations in patients with inflammatory bowel disease (IBD), but post-marketing reports describing gastritis and gastric ulceration have been sporadically reported, and the occurrence of gastric erosive disease in non-IBD patients has not been extensively documented. This study aimed to assess the occurrence of erosive gastritis in adult patients who received OST bowel preparation compared to patients who received PEG prior to same-day esophagogastroduodenoscopy (EGD) and colonoscopy. Methods: A single-center, blinded, retrospective study was conducted of adults who underwent same-day EGD and colonoscopy. A total of 177 patients who received OST were matched with 219 patients who received PEG. Data collection involved a detailed review of the patients' demographics, procedural, and pathology reports. Results: The OST group demonstrated a significantly higher incidence of both gastric ulcers (13.6% vs. 2.3%, P-value < 0.001) and erosions (16.9% vs. 5.0%, P-value < 0.001) compared to the PEG group. There was no statistically significant difference between the locations of erosions and ulcers between groups. Conclusion: The use of OST bowel preparation prior to colonoscopy is associated with increased incidence of erosive gastritis compared to PEG in patients undergoing EGD and colonoscopy on the same day at our center. Prospective, randomized studies are needed to definitively establish the risks associated with OST and to evaluate the mechanism by which it may increase the occurrence of mucosal injury.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".