Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 10, 2016; 8(15): 508-516
Published online Aug 10, 2016. doi: 10.4253/wjge.v8.i15.508
Sensory characterization of bowel cleansing solutions
Ala I Sharara, Hamza Daroub, Camille Georges, Rani Shayto, Ralph Nader, Jean Chalhoub, Ammar Olabi
Ala I Sharara, Rani Shayto, Ralph Nader, Jean Chalhoub, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, American University of Beirut, Beirut 1107 2020, Lebanon
Hamza Daroub, Camille Georges, Ammar Olabi, Nutrition and Food Sciences Department, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut 1107 2020, Lebanon
Author contributions: Sharara AI and Olabi A designed the research study, wrote the protocol, and drafted the manuscript; Nader R and Chalhoub J conducted literature searches and provided summaries of previous research studies; Daroub H, Georges C and Shayto R contributed equally to this work; Daroub H and Georges C recruited subjects, conducted experimental trials, collected data, and executed tables and figures; Shayto R interpreted the data; Olabi A performed the statistical data analysis; all authors contributed to and approved the final manuscript.
Institutional review board statement: The study protocol was reviewed and approved by the American University of Beirut Institutional Review Board on June 29, 2015 and the study was registered with clinicaltrial.gov identifier: NCT02642783.
Informed consent statement: All study participants provided written informed consent for descriptive analysis and verbal consent for hedonic evaluation.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Ammar Olabi, Associate Professor, Nutrition and Food Sciences Department, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon. ammar.olabi@aub.edu.lb
Telephone: +961-1-374374-4500 Fax: +961-1-744460
Received: January 16, 2016
Peer-review started: January 18, 2016
First decision: February 22, 2016
Revised: February 29, 2016
Accepted: May 7, 2016
Article in press: May 9, 2016
Published online: August 10, 2016
Processing time: 201 Days and 19.4 Hours
Abstract

AIM: To evaluate the sensory characteristics of commercial bowel cleansing preparations.

METHODS: Samples of 4 commercially available bowel cleansing preparations, namely polyethylene glycol electrolyte solution (PEG), PEG + ascorbic acid (PEG-Asc), sodium picosulfate (SPS), and oral sodium sulfate (OSS) were prepared according to the manufacturer’s instructions. Descriptive analysis was conducted (n = 14) using a 15-cm line scale with the Compusense at-hand® sensory evaluation software. Acceptability testing (n = 80) was conducted using the 9-point hedonic scale. In addition, a Just-About-Right (JAR) scale was included for the four basic tastes to determine their intensity compatibility with acceptability levels in the products.

RESULTS: Samples were significantly different, in descriptive analysis, for all attributes (P < 0.05) except for sweetness. SPS received the highest ratings for turbidity, viscosity appearance, orange odor and orange flavor; PEG-Asc for citrus odor and citrus flavor; OSS for sweetener taste, sweet aftertaste, bitterness, astringency, mouthcoating, bitter aftertaste and throatburn, and along with PEG-Asc, the highest ratings for saltiness, sourness and adhesiveness. Acceptability results showed significant differences between the various samples (P < 0.05). SPS received significantly higher ratings for overall acceptability, acceptability of taste, odor and mouthfeel (P < 0.05). JAR ratings showed that PEG and PEG-Asc were perceived as slightly too salty; SPS and OSS were slightly too sweet, while SPS, PEG-Asc and OSS were slightly too sour and OSS slightly too bitter. While using small sample volumes was necessary to avoid unwanted purgative effects, acceptability ratings do not reflect the true effect of large volumes intake thus limiting the generalization of the results.

CONCLUSION: Further improvements are needed to enhance the sensory profile and to optimize the acceptability for better compliance with these bowel cleansing solutions.

Keywords: Laxatives; Acceptability; Sensory evaluation; Taste; Preparation; Colonoscopy

Core tip: Bowel preparation is an important quality indicator in colonoscopy. Purgative solutions are generally poorly tolerated and may serve as an impediment to colorectal cancer screening and surveillance. The need for rapid ingestion of these solutions is perceived as a major disadvantage concerning patient adherence as these solutions are often considered unpleasant. To date, no major studies have investigated the sensory properties of bowel cleansing solutions using comprehensive sensory evaluation techniques. This study showed major differences in sensory characteristics and the need for product development to optimize patient acceptability for better compliance with bowel cleansing solutions.