ASGE Annual GI Advanced Practice Provider Course (Virtual) - Onboarding Day One | April 2022-07_Bowel Prep Before Colonoscopy

07_Bowel Prep Before Colonoscopy - Olmstead

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This document provides information on bowel preparation before colonoscopy. The author discusses various aspects related to bowel cleansing, including timing of preparation, regimens for colonic cleansing, adjunctive measures, diet during bowel cleansing, and selection of bowel preparation in specific populations.<br /><br />The timing of preparation is important, with a split dose preferred regimen that involves taking two doses - one the day before the procedure and the second a few hours prior to the procedure. Isosmotic, hyposmotic, hyperosmotic, and combination agents are used for colonic cleansing, with polyethylene glycol (PEG) being a commonly used agent. Other options include low-volume PEG preparations, hypomotic agents like Suprep, and hyperosmotic agents like sodium phosphate.<br /><br />The author emphasizes the importance of considering special populations when selecting a bowel preparation. For instance, magnesium citrate and sodium sulfate should be avoided in the elderly and those with renal disease. Additionally, specific recommendations are lacking for individuals with inflammatory bowel disease or who have undergone bariatric surgery.<br /><br />Adjunctive measures, such as clear liquids, full liquids, and low residue diets, can be implemented during bowel cleansing. In cases of inadequate preparation, salvage options include enemas and additional bowel preparation on the day of the procedure or next day.<br /><br />The document concludes by noting that there is insufficient evidence to recommend a single salvage strategy for inadequate preparation and failed previous prep and constipation. Split dosing, choosing the appropriate preparation, and considering a low residue diet can help improve patient tolerance.<br /><br />Overall, this document provides a comprehensive overview of bowel preparation before colonoscopy, highlighting considerations for timing, choice of preparation, and special populations.

Keywords

bowel preparation

colonoscopy

bowel cleansing

timing of preparation

regimens for colonic cleansing

adjunctive measures

diet during bowel cleansing

selection of bowel preparation

special populations

salvage options