Patient Characteristics Associated With Preference for 480‐mL Oral Sodium Sulfate: A Prospective Clinical Study on Bowel Cleansing Efficacy and Taste Acceptability for Total Colonoscopy

ABSTRACT Background and Aims Oral sulfate solutions (OSSs) are used for low‐volume bowel preparation but have a distinctive bitter taste. This study evaluated the efficacy and tolerability of OSSs compared with polyethylene glycol plus ascorbate (PEG‐ASC) and identified patient factors associated with favorable acceptability. Methods In this prospective single‐center study, patients undergoing colonoscopy using OSSs who had used PEG‐ASC for a previous colonoscopy within 2 years were enrolled. Cleansing quality (Boston Bowel Preparation Scale [BBPS]), ingested volume, adverse events, patient preference, and taste acceptability were assessed. Outcomes were also compared between elderly (≥75 years) and non‐elderly patients. Results Among 263 patients, 98% achieved satisfactory cleansing (BBPS ≥ 6). Overall, 54% preferred OSS for their next procedure. Multivariate analysis identified favorable taste acceptability as the strongest predictor of preference (odds ratio [OR], 4.88). Favorable taste acceptability tended to be associated with male sex (OR, 1.58; p = 0.09) and age ≥ 75 years (OR, 1.69; p = 0.07). Older male patients showed significantly higher favorable taste acceptability than younger female patients (63% vs. 40%; p = 0.03). Elderly patients had lower total fluid intake ( p = 0.04) and fewer adverse events ( p < 0.01), particularly nausea, while maintaining cleansing quality equivalent to non‐elderly patients. Conclusions OSS provided high‐quality cleansing with a reduced intake volume. Elderly patients tended to have favorable taste acceptability for OSS, and effective cleansing was achieved with even lower total fluid intake and fewer adverse events. OSS represents an advantageous bowel preparation option for the aging population. Trial Registration UMIN‐CTR: UMIN000052571.