Two cases of hematemesis caused by polyethylene glycol electrolytes powder (Ⅱ) during bowel preparation

doi:10.19803/j.1672-8629.20260120

Abstract

Abstract: Objective To analyze the clinical characteristics of hematemesis induced by polyethylene glycol electrolytes powder (Ⅱ) for bowel preparation, explore the possible mechanisms and risk factors, and provide references for safe clinical medication. Methods Two cases of hematemesis due to severe vomiting after administration were retrospectively analyzed. Based on a literature review, the mechanisms, causality, potential triggers, and preventive measures were explored. Results Correlation analysis showed that hematemesis was associated with polyethylene glycol electrolytes powder (Ⅱ) in these two patients. Symptoms improved after drug discontinuation, acid suppression and symptomatic treatment with favorable prognosis. Conclusion Despite its safety, polyethylene glycol electrolytes powder may cause severe vomiting, hematemesis or even Mallory-Weiss Syndrome. Physicians should evaluate risk factors beforehand and control administration speed to prevent severe vomiting and ensure safe medication.

Key words: Polyethylene Glycol Electrolytes Powder (Ⅱ), Bowel Preparation, Hematemesis, Mallory-Weiss Syndrome (MWS), Adverse Drug Reaction

CLC Number:

Zhang Yumao, Liu Junbo, Luo Qianjiang, Tan Binying, Deng Bin, Xing Weiqing, Li Yuzhen. Two cases of hematemesis caused by polyethylene glycol electrolytes powder (Ⅱ) during bowel preparation[J]. Chinese Journal of Pharmacovigilance, 2026, 23(8): 931-933.

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URL: https://zgywjj.magtechjournal.com/EN/10.19803/j.1672-8629.20260120

https://zgywjj.magtechjournal.com/EN/Y2026/V23/I8/931

References

[1] Jacobson B C, Anderson J C, Burke C A, et al.Optimizing bowel preparation quality for colonoscopy: consensus recommendations by the US multi-society task force on colorectal cancer[J]. American Journal of Gastroenterology, 2025, 120(4): 738-764.
[2] Areia M, Esposito G, Leclercq P, et al.Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative-update 2025[J]. Endoscopy, 2025, 57(11): 1268-1297.
[3] Ye Hong, Zhao Yun.A case report of Mallory-Weiss syndrome caused by compound polyethylene glycol electrolyte powder[J]. Herald of Medicine(医药导报), 2006, 25(9): 971.
[4] Xiao Qili.Mallory-Weiss syndrome caused by oral compound polye-thylene glycol electrolyte powder: a case report[J]. Modern Diagnosis and Treatment(现代诊断与治疗), 2017, 28(22): 4285-4286.
[5] Jia Zhengwo, Shen Jingen, Zhang Xicheng, et al.A case report of Mallory-Weiss syndrome caused by bowel preparation with oral Compound Polyethylene Glycol Electrolyte powder (Ⅱ)[J]. Zhongguo Xiangcun Yiyao(中国乡村医药), 2022, 29(16): 51.
[6] Brinberg D E, Stein J.Mallory-Weiss tear with colonic lavage[J]. Annals of Internal Medicine, 1986, 104(6): 894-895.
[7] Hroncich M E.Colonoscopy preparation complicated by Mallory-Weiss tear[J]. Southern Medical Journal, 1992, 85(3): 328.
[8] Raymond P L.Mallory-Weiss tear associated with polyethylene glycol electrolyte lavage solution[J]. Gastrointestinal Endoscopy, 1991, 37(3): 410-411.
[9] Schwartz T.Polyethylene glycol electrolyte lavage solution-induced Mallory-Weiss tear[J]. Gastroenterology Nursing, 1995, 18(6): 233-234.
[10] Santoro M J, Chen Y K, Collen M J.Polyethylene glycol electrolyte lavage solution-induced Mallory-Weiss tears[J]. American Journal of Gastroenterology, 1993, 88(8): 1292-1293.
[11] Liu Min, Wang Haixue.Overview of causality evaluation methods for adverse reactions in drug clinical trials and consideration of existing problems[J]. The Chinese Journal of Clinical Pharmacology(中国临床药理学杂志), 2023, 39(8): 1206-1211.
[12] Gelrud A. Mallory-Weiss syndrome[DB/OL]. Laine L, ed. UpToDate. Wolters Kluwer. (2025-12-22)[2026-01-05]. https://www.uptodate.com/contents/mallory-weiss-syndrome.
[13] Mertens A, Essing T, Roderburg C, et al.A systematic analysis of incidence, therapeutic strategies, and in-hospital mortality of Mallory-Weiss syndrome in Germany[J]. Journal of Clinical Gastroenterology, 2024, 58(7): 640-649.
[14] Hassanein M, Larue K, Sani A, et al.Efficacy and safety of mono-polar coagulation forceps in the repair of large Mallory-Weiss tear in patients with massive upper gastrointestinal bleeding, 2 case reports[J]. American Journal of Internal Medicine, 2025, 13(2): 11-15.
[15] Kortas D Y, Haas L S, Simpson W G, et al.Mallory-Weiss tear: predisposing factors and predictors of a complicated course[J]. American Journal of Gastroenterology, 2001, 96(10): 2863-2865.
[16] Hu Z, Liu D.Mallory-Weiss syndrome[J]. New England Journal of Medicine, 2024, 390(20): e49.
[17] Huang L, Li C, Jiang Y Z, et al.Vitamin drinks improve palatability and reduce adverse events associated to polyethylene glycol electrolyte solutions[J]. Heliyon, 2024, 10(17): e37590.
[18] Bednarska O, Nyhlin N, Schmidt P T, et al.The effectiveness and tolerability of a very low-volume bowel preparation for colonoscopy compared to low and high-volume polyethylene glycol-solutions in the real-life setting[J]. Diagnostics (Basel), 2022, 12(5), 1155.
[19] Yan X J, Xu P, Qiu H Y, et al.Antiemetics improve the tolerance of polyethylene glycol for colonoscopy preparation: a randomized clinical trial[J]. Medicine (Baltimore), 2021, 100(10): e24947.