Optimal bowel preparation - A practical guide for clinicians

Douglas K. Rex

Research output: Contribution to journalReview article

33 Scopus citations

Abstract

High-quality bowel preparation is essential for effective colonoscopy. Bowel preparations are judged by their safety, efficacy and tolerability. Between efficacy and tolerability, efficacy is the clinical priority because inadequate preparations are disruptive and costly. Achieving high rates of adequate preparation depends first on using split-dose or same-day dosing. Patients who have medical predictors of inadequate preparation quality (for example chronic constipation) should be prescribed more aggressive preparations and patients who have factors that predict they are less likely to follow the instructions (such as English not being their first language) should receive intensified education. On the day of the procedure, patients with persistent brown effluent should be considered for large-volume enemas or additional oral preparation before proceeding with colonoscopy. During the procedure, preparation quality should be graded after the clean-up has been completed.

Original languageEnglish (US)
Pages (from-to)419-425
Number of pages7
JournalNature Reviews Gastroenterology and Hepatology
Volume11
Issue number7
DOIs
StatePublished - Jul 2014

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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