Bowel cleansing before colonoscopy: Balancing efficacy, safety, cost and patient tolerance

World Journal of Gastrointestinal Endoscopy
Nicole M Harrison, Michael C Hjelkrem

Abstract

Effective colorectal cancer screening relies on reliable colonoscopy findings which are themselves dependent on adequate bowel cleansing. Research has consistently demonstrated that inadequate bowel preparation adversely affects the adenoma detection rate and leads gastroenterologists to recommend earlier follow up than is consistent with published guidelines. Poor preparation affects as many as 30% of colonoscopies and contributes to an increased cost of colonoscopies. Patient tolerability is strongly affected by the preparation chosen and manner in which it is administered. Poor tolerability is, in turn, associated with lower quality bowel preparations. Recently, several new developments in both agents being used for bowel preparation and in the timing of administration have brought endoscopists closer to achieving the goal of effective, reliable, safe, and tolerable regimens. Historically, large volume preparations given in a single dose were administered to patients in order to achieve adequate bowel cleansing. These were poorly tolerated, and the unpleasant taste of and significant side effects produced by these large volume regimens contributed significantly to patients' inability to reliably complete the preparation and ...Continue Reading

Citations

May 31, 2018·European Journal of Gastroenterology & Hepatology·Sultan MahmoodMohammad F Madhoun
Aug 2, 2017·Expert Opinion on Drug Safety·Blanca Serrano-Falcón, Enrique Rey
Mar 14, 2019·The American Journal of Gastroenterology·Kathleen ZawalyHarminder Singh
May 8, 2020·Current Gastroenterology Reports·Valentine Ongeri Millien, Nabil M Mansour
Jun 18, 2019·Therapeutic Advances in Gastroenterology·Lawrence HookeyStuart P Brogadir
May 27, 2020·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Zeynep Kızılcık Özkan, Ümmü Yıldız Fındık
Jul 28, 2021·Scandinavian Journal of Gastroenterology·Christian PrimasHarald Vogelsang

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