Updated bowel preparation regimens for colonoscopy: benefits and drawbacks

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Prevention

Background:

• Optimal bowel preparation is crucial for high-quality colonoscopies and colorectal cancer prevention.
• Traditional high-volume polyethylene glycol (PEG) solutions face tolerability issues, impacting patient adherence.
• Emerging low-volume PEG and hyperosmotic alternatives offer improved compliance and efficacy.

Purpose of the Study:

• To review the evolving landscape of bowel preparation options for colonoscopy.
• To compare the efficacy, tolerability, and patient compliance of various bowel preparation regimens.
• To emphasize the importance of personalized regimen selection based on patient characteristics.

Main Methods:

• Review of current literature on bowel preparation agents.
• Comparison of efficacy and tolerability data for different preparation types (PEG, oral sulfate solutions, tablets).
• Discussion of factors influencing patient adherence and procedural outcomes.

Main Results:

• Low-volume PEG and hyperosmotic agents demonstrate noninferior efficacy to traditional high-volume PEG.
• Oral sulfate solutions and tablets offer improved palatability and tolerability.
• Oral sulfate tablets provide convenience with comparable efficacy and enhanced tolerability, though rare gastric irritation is noted.
• Adjunctive simethicone improves mucosal visualization by reducing bubbles.

Conclusions:

• Personalized, evidence-based selection of bowel preparation regimens is essential.
• Tailoring choices to patient factors (age, comorbidities, preferences) improves adherence and bowel cleansing.
• Optimized bowel preparation enhances colonoscopy's diagnostic yield and procedural efficiency.