{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:07:53Z","timestamp":1785308873586,"version":"3.55.0"},"reference-count":30,"publisher":"The Korean Society of Gastrointestinal Endoscopy","issue":"4","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-ce.org"],"crossmark-restriction":true},"short-container-title":["Clin Endosc"],"published-print":{"date-parts":[[2026,7,30]]},"abstract":"<jats:p>Background\/Aims: Adequate bowel preparation is essential for high-quality colonoscopy; however, older adults often struggle with large-volume regimens. Low-volume oral sulfate (OS)-based and polyethylene glycol-ascorbate (PEG-Asc) may improve tolerability without compromising efficacy. This study compared the efficacy, tolerability, and safety of these regimens in older adults.Methods: We searched the PubMed, Embase, and Cochrane databases from inception until May 2025 for randomized controlled trials comparing OS with low-volume PEG-Asc in adults aged \u226565 years. Outcomes were pooled using random-effects models as risk ratios (RRs) or mean differences (MDs).Results: Six trials (n=682; OS, 340; PEG-Asc, 342) were included. The overall cleansing success rates were comparable (RR, 1.00; 95% confidence interval [CI], 0.96\u20131.03). Total Boston bowel preparation scale and segmental scores did not significantly differ between the groups (MD, 0.08; 95% CI, \u22120.10 to 0.27). OS improved lesion detection in terms of polyp detection (RR, 1.21; 95% CI, 1.01\u20131.45) and adenoma detection rates (RR, 1.28; 95% CI, 1.10\u20131.49). Patient-reported satisfaction modestly favored OS compared with PEG-Asc (MD, 0.69; 95% CI, 0.10\u20131.29), whereas willingness to reuse was similar between the two groups (RR, 1.09; 95% CI, 0.97\u20131.23). Adverse events and procedural metrics did not significantly differ between the groups.Conclusions: In adults aged \u226565 years, OS and low-volume PEG-Asc achieved similar cleansing quality and safety. OS may confer higher polyp and adenoma detection rates than PEG-Asc and may be a reasonable option for maximizing lesion detection.<\/jats:p>","DOI":"10.5946\/ce.2025.430","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:47:27Z","timestamp":1785307647000},"page":"557-568","update-policy":"https:\/\/doi.org\/10.5946\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral sulfate-based versus low-volume polyethylene glycol-ascorbate regimens for colonoscopy preparation in the geriatric population: a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.5946","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3073-8538","authenticated-orcid":true,"given":"Ali 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