Updates Issued for Optimizing Bowel Preparation Quality for Colonoscopy

Mar 07, 2025

THURSDAY, March 6, 2025 (HealthDay News) — In updated consensus recommendations published online March 4 in the American Journal of Gastroenterology, additional guidance is presented for optimizing bowel preparation quality for colonoscopy.

Brian C. Jacobson, M.D., M.P.H., from Massachusetts General Hospital in Boston, and colleagues developed consensus statements and key clinical concepts addressing aspects of bowel preparation for colonoscopy to update the 2014 recommendations for optimizing the adequacy of bowel cleansing.

The authors noted that most of the consensus statements focus on individuals at average risk for inadequate bowel preparation; statements are also provided addressing individuals at risk for inadequate bowel preparation quality. Use of a split-dose bowel preparation regimen is recommended; and a 2-liter regimen is suggested as sufficient. For individuals undergoing afternoon colonoscopy, a same-day regimen is recommended as an acceptable alternative; however, for individuals undergoing morning colonoscopy, a same-day regimen is inferior. Dietary restrictions should be limited to the day before a colonoscopy; for early and midday meals, clear liquids or low-fiber/low-residue diets should be relied on. Adjunctive use of oral simethicone is suggested for bowel preparation before colonoscopy. There is also a recommendation for routine tracking of the rate of adequate bowel preparations at the level of individual endoscopists and the endoscopy unit, with a target >90 percent for both rates.

“Bowel preparation is a vital part of colonoscopy. If the colon is not adequately cleaned, the person performing the colonoscopy may miss important findings such as small polyps,” Jacobson said in a statement. “Many cases end up cancelled when the bowel preparation is inadequate, and that creates tremendous frustration for patients and inefficient use of resources.”

Several authors disclosed ties to the biopharmaceutical and medical device industries.

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