Clinical updates in bowel preparation for colonoscopy.

Area of Science:

• Gastroenterology
• Endoscopy
• Preventive Medicine

Background:

• Colonoscopy is vital for colorectal cancer (CRC) screening.
• Suboptimal bowel preparation (BP) affects up to 44% of colonoscopies.
• Poor BP compromises lesion detection, increases procedure time, and raises healthcare costs.

Purpose of the Study:

• To review evidence-based strategies for improving colonoscopy bowel preparation.
• To highlight effective polyethylene glycol (PEG) regimens and adjunctive agents.
• To discuss factors influencing BP quality and emerging personalized approaches.

Main Methods:

• Narrative review of existing literature on bowel preparation strategies.
• Analysis of high-volume, low-volume, and very-low-volume PEG regimens.
• Evaluation of adjunctive agents, dietary modifications, and timing of preparation.

Main Results:

• Split-dose and same-day regimens (with <5h interval) improve cleansing and adenoma detection.
• Very-low-volume PEG options offer better patient tolerance.
• A 1-day low-fiber diet enhances compliance; adjunctive agents benefit specific patient groups.

Conclusions:

• Optimizing BP is essential for high-quality colonoscopy and effective CRC screening.
• Patient-centered, risk-adapted strategies, including newer preparations and personalized tools, are key.
• Improved BP can reduce CRC incidence and associated healthcare burdens.