Abstract
Bowel preparation is a critical part of colonoscopy
and has the potential to reduce deaths from cancer
with many countries introducing national screening programs.
For colonoscopy to be successful, it is necessary for
the endoscopist to detect and remove premalignant adenomatous
polyps. Some adenomatous and sessile serrated
polyps can be flat and subtle. Therefore, the effectiveness of
colonoscopy is dependent on the identification of subtle
early changes. Although there has been considerable discussion
around colonoscope resolution and image enhancement
techniques, none of these developments are of value if the
colon is not completely clean, and it is established that poor
bowel preparation leads to lesions being missed. Therefore,
the importance of high-quality bowel preparation cannot be
underestimated. In particular, although there are many
preparations and regimens available, patient compliance
with bowel cleansing can be a significant issue, with one in
seven patients showing a lack of compliance with a standard
split-dose regimen. Much of the controversy surrounding
bowl cleansing has centered around how the dose should be
given. Evidence has emerged from several well-conducted
studies suggesting that split-dose preparation is superior to
single-dose delivery in achieving adequate bowel cleansing. Such regimens have involved the patient taking some
bowel preparation the day before the procedure with further
medication given on the morning of colonoscopy. Furthermore,
there are data emerging that suggest that the final dose
needs to be given as close to the procedure as possible,
ideally within 5 h of colonoscopy.
Original language | English |
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Pages (from-to) | 707-708 |
Journal | Digestive endoscopy |
Volume | 26 |
Issue number | 6 |
Early online date | 17 Oct 2014 |
DOIs | |
Publication status | Published - 1 Nov 2014 |