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

...ecommendat...

...nary assessment of preparation quality shoul...


...copy is complete to cecum, and the preparatio...


...tion is deemed adequate and the colonoscopy is co...


Dosing and Timing of Colon Cleansing Regimens

...ng and Timing of Colon Cleansing...

...dose bowel cleansing regimen is strongly...


...regimen is an acceptable alternative to split...


...of split preparation ideally should begin 4...


Diet During Bowel Cleansing

...et During Bowel Cleansing

...ing a split-dose bowel cleansing regimen, di...


Usefulness of Patient Education and Navigators for Optimizing Preparation Results

...of Patient Education and Navigators for Optim...

...are professionals should provide both oral and wr...


...performing the colonoscopy should ensure that...


Rating the Quality of Bowel Preparation During Colonoscopy

...e Quality of Bowel Preparation During Colonoscopy...

...of bowel preparation should be assessed...


...rement of the rate of adequate colon c...


...tion, defined as cleansing that allow...


FDA-Approved Preparations

...pproved Preparations

...f a bowel-cleansing regimen should take...


...t-dose regimen of 4-L PEG-ELS provides high-...


...healthy nonconstipated individuals, a 4-L PEG-...


OTC Non-FDA-Approved Preparations

...TC Non-FDA-Approved Preparation...

...l cleansing agents have variable efficacy that ra...


...OTC purgatives generally are safe, caution is...