Taste aversion as an under-recognized determinant of bowel preparation quality

Inadequate bowel preparation remains a major barrier to high-quality colonoscopy, with taste aversion representing a common yet under-recognized contributor to poor tolerability of the bowel preparation. Current strategies primarily aim to improve palatability through formulation changes or dosing regimens. This paper proposes a novel, hypothesis-driven approach: transient pharmacologic suppression of gustatory perception using topical oral lidocaine to reduce the perceived unpleasantness of bowel preparation solutions. The concept arises from a serendipitous clinical observation in which tongue-focused lidocaine application enabled successful oral intake in a patient with repeated prior intolerance. By targeting taste perception directly rather than modifying the preparation itself, this approach may offer a complementary strategy for selected patients. Further evaluation is required to assess feasibility, safety, and clinical effectiveness.