Bowel Cleansing
Key Points
Key Points
- Colonoscopy is used widely for colorectal cancer (CRC) screening and surveillance and the diagnostic evaluation of symptoms and other positive CRC screening tests.
- The success of colonoscopy is linked closely to the adequacy of preprocedure bowel cleansing.
- Up to 20%–25% of all colonoscopies are reported to have an inadequate bowel preparation. The Multi-Society Task Force sets a new benchmark that at least 85% of all colonoscopies are rated as adequate on a per-physician basis.
- Adverse consequences of ineffective bowel preparation include lower adenoma detection rates, longer procedural time, lower cecal intubation rates, increased electrocautery risk, and shorter intervals between examinations.
- Consequently, the choice of a bowel cleansing regimen should be based on cleansing efficacy first and patient tolerability second.
Recommendations
...mmendation...
...ssment of preparation quality should be mad...
...oscopy is complete to cecum, and the prepa...
...f the preparation is deemed adequate and the colon...
...Timing of Colon Cleansing Regimens...
...a split-dose bowel cleansing regimen is stro...
...same-day regimen is an acceptable alternative t...
...se of split preparation ideally should b...
...uring Bowel Cleansing...
...g a split-dose bowel cleansing regimen, diet rec...
...ess of Patient Education and Navigators for Optimi...
...professionals should provide both oral and wri...
...performing the colonoscopy should ensure t...
...e Quality of Bowel Preparation During Colonos...
...quacy of bowel preparation should be assess...
...t of the rate of adequate colon cleansing should b...
...ation, defined as cleansing that al...
...pproved Preparati...
Selection of a bowel-cleansing regi...
...egimen of 4-L PEG-ELS provides high-quality...
...onstipated individuals, a 4-L PEG-ELS formula...
...Non-FDA-Approved Preparations...
...bowel cleansing agents have variab...
...e OTC purgatives generally are safe, caution is r...
Adjuncts to Colon Cleansing Befo...
...of adjunctive agents for bowel cleansing befor...
Differences in Patient Preference/Willin...
...cleansing is associated with greater willin...
...use of low-volume bowel cleansing age...
...lection of Bowel Preparation in Specific Popul...
There is insufficient evidence to recomm...
...here is insufficient evidence to recomme...
...oided in patients with known or suspec...
...al bowel purgatives should be considered in p...
...parations or extended time delivery fo...
...nemas should be used to prepare the colon fo...
...insufficient evidence to recommend sp...
...vage Options for Inadequate Prep...
...emas can be attempted for patients who,...
...cope enema with completion colonoscopy on the...
...ng the patient entirely from sedation...
Evaluation
...valuation
Table 1. Aronchick Bowel Preparation Sca...
...ble 2. Boston Bowel Preparation ScaleHa...
Figure 1. Ottawa ScaleThe Ottawa bowel p...