Preparation for colonoscopy: Recommendations by an expert panel in Italy

Area of Science:

• Gastroenterology
• Endoscopy
• Clinical Practice Guidelines

Background:

• International guidelines for bowel preparation exist but their application in Italy is not well understood.
• There's a need to adapt and validate these guidelines for the Italian healthcare context.

Purpose of the Study:

• To establish expert-based recommendations for bowel preparation tailored to the Italian setting.
• To evaluate the level of consensus among Italian endoscopy professionals regarding these recommendations.

Main Methods:

• A two-phase study involving statement formulation and consensus assessment by experts.
• Six key topics were addressed: efficacy, tolerability, timing, quality assessment, factors affecting preparation, patient education, and organizational influences.
• Consensus was defined as agreement by at least 70% of participants.

Main Results:

• Twenty-five statements achieved expert agreement in the initial phase.
• Consensus was not reached on seven statements, primarily related to practical management of inadequate preparation and organizational factors.
• Significant agreement was found on the choice of laxatives and their administration timing.

Conclusions:

• A clinically meaningful consensus on major bowel preparation elements was achieved, potentially unifying colonoscopy practices in Italy.
• Specific Italian-contextual preparation challenges remain and need further investigation.
• The recommendations can guide standardized colonoscopy preparation across Italy.