Oral sulfate solution as a modern approach to bowel preparation for colonoscopy: evidence and clinical data

Czech version

Authors: V. Kojecký ^1,2
Authors‘ workplace: Interní oddělení, Krajská nemocnice Tomáše Bati, a. s., Zlín2 II. interní klinika LF MU a FN u sv. Anny v Brně ¹
Published in: Gastroent Hepatol 2026; 80(3): 208-211
Category: Digestive Endoscopy: Review Article
doi: https://doi.org/10.48095/ccgh2026208

Overview

The outcome of colonoscopy largely depends on the quality of bowel preparation. Inadequate cleansing increases the risk of missed lesions and the number of incomplete or unsuccessful colonoscopies. Optimal preparation should achieve adequate bowel cleansing in at least 95% of colonoscopies. Several factors influence the quality of preparation. Some cannot be modified (such as age or comorbidities), whereas others –⁠ such as patient education, diet, and preparation regimen –⁠ can be optimized. The current standard is the split-dose regimen. The traditional 4-liter polyethylene glycol solution has long represented a well-established standard for bowel preparation. In recent years, lower--volume (“low-volume”) preparations have also entered clinical practice, aiming to improve tolerability while maintaining comparable efficacy. The latest trend involves “ultra-low volume” regimens with a total volume of around 1 liter. However, most of these regimens do not achieve sufficient efficacy. An exception is the oral sulfate solution (OSS), which in a split-dose regimen achieves adequate bowel cleansing in more than 90% of patients and a higher adenoma detection rate compared with other preparations. OSS is characterized by very good tolerability and a favorable safety profile. With appropriate hydration, it currently represents an effective option for bowel preparation prior to colonoscopy.

Keywords:

colonoscopy – bowel preparation – oral sulfate solution

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