Bowel Cleansing

Publication Date: October 1, 2014

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

...Recomm...

...sessment of preparation quality should be ma...


...f the colonoscopy is complete to cecum,...


...e preparation is deemed adequate and the co...


Dosing and Timing of Colon Cleansing Regimens

...Dosing and Tim...

...it-dose bowel cleansing regimen is strongly r...


...men is an acceptable alternative to s...


...se of split preparation ideally should b...


Diet During Bowel Cleansing

...Diet During...

...split-dose bowel cleansing regimen, diet re...


Usefulness of Patient Education and Navigators for Optimizing Preparation Results

Useful...

...care professionals should provide both...


...sician performing the colonoscopy shoul...


Rating the Quality of Bowel Preparation During Colonoscopy

...Rating...

...wel preparation should be assessed after all...


...the rate of adequate colon cleansing shou...


...paration, defined as cleansing that allows a r...


FDA-Approved Preparations

...FDA-Approved Preparatio...

...a bowel-cleansing regimen should take into cons...


A split-dose regimen of 4-L PEG-ELS pro...


...nstipated individuals, a 4-L PEG-ELS formulation...


OTC Non-FDA-Approved Preparations

...OTC Non-FDA...

...bowel cleansing agents have variable eff...


...hough the OTC purgatives generally are safe, cau...