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

Recommenda...

...liminary assessment of preparation quality shou...


...he colonoscopy is complete to cecum, and the prep...


...the preparation is deemed adequate and the...


Dosing and Timing of Colon Cleansing Regimens

...osing and Timing of Colon Cleansi...

...a split-dose bowel cleansing regimen is strongly...


...ame-day regimen is an acceptable alternative to sp...


...ose of split preparation ideally should be...


Diet During Bowel Cleansing

...ng Bowel Cleansing

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


Usefulness of Patient Education and Navigators for Optimizing Preparation Results

...ness of Patient Education and Navigators for Opti...

...re professionals should provide both oral an...


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


Rating the Quality of Bowel Preparation During Colonoscopy

...e Quality of Bowel Preparation During Colono...

...el preparation should be assessed aft...


...asurement of the rate of adequate c...


...reparation, defined as cleansing tha...


FDA-Approved Preparations

...pproved Preparation...

...tion of a bowel-cleansing regimen should take...


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


...onconstipated individuals, a 4-L PEG...


OTC Non-FDA-Approved Preparations

...-FDA-Approved Preparatio...

...he OTC bowel cleansing agents have...


...h the OTC purgatives generally are safe, caution...