Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2019

Cesare Hassan; James East; Franco Radaelli; Cristiano Spada; Robert Benamouzig; Raf Bisschops; Michael Bretthauer; E. Dekker; Mario Dinis-Ribeiro; Monika Ferlitsch; Lorenzo Fuccio; Halim Awadie; Ian Gralnek; Rodrigo Jover; Michal F. Kaminski; Maria Pellisé; Konstantinos Triantafyllou; Giuseppe Vanella; Carolina Mangas-Sanjuan; Leonardo Frazzoni; Jeanin E. Van Hooft; Jean-Marc Dumonceau

doi:10.1055/a-0959-0505

Endoscopy, Table of Contents

Endoscopy 2019; 51(08): 775-794
DOI: 10.1055/a-0959-0505

Guideline

Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2019

Authors

Cesare Hassan

¹Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy
James East

²Translational Gastroenterology Unit, John Radcliffe Hospital, University of Oxford, and Oxford NIHR Biomedical Research Centre, Oxford, United Kingdom
Franco Radaelli

³Valduce Hospital, Como, Italy
Cristiano Spada

⁴Digestive Endoscopy Unit, Fondazione Poliambulanza, Brescia, Italy
Robert Benamouzig

⁵Gastroenterology Unit, Bobigny, France
Raf Bisschops

⁶University Hospitals Leuven, KU Leuven, Department of Gastroenterology and Hepatology
Michael Bretthauer

⁷Institute of Health and Society, University of Oslo Department of Transplantation Medicine, Oslo University Hospital, Norway
E. Dekker

⁸Department of Gastroenterology and Hepatology Amsterdam University Medical Centers, Amsterdam, The Netherlands
Mario Dinis-Ribeiro

⁹CIDES/CINTESIS, Faculty of Medicine, University of Porto, Porto, Portugal
Monika Ferlitsch

¹⁰Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Medical University of Vienna, Austria; Austrian Society of Gastroenterology and Hepatology (OEGGH): Quality Assurance Working Group, Austria
Lorenzo Fuccio

¹¹Gastroenterology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
Halim Awadie

¹²Institute of Gastroenterology and Hepatology Emek Medical Center Afula, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel
Ian Gralnek

¹²Institute of Gastroenterology and Hepatology Emek Medical Center Afula, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel
Rodrigo Jover

¹³Servicio de Medicina Digestiva. Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria ISABIAL, Alicante, Spain
Michal F. Kaminski

¹⁴Department of Gastroenterology, Hepatology and Oncology, Center for Postgraduate Medical Education, Warsaw, Poland
Maria Pellisé

¹⁵Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
Konstantinos Triantafyllou

¹⁶Ηepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Athens University, Athens Greece
Giuseppe Vanella

¹⁷Digestive Disease Unit, Sant'Andrea Hospital, Sapienza University of Rome, Italy
Carolina Mangas-Sanjuan

¹³Servicio de Medicina Digestiva. Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria ISABIAL, Alicante, Spain
Leonardo Frazzoni

¹¹Gastroenterology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
Jeanin E. Van Hooft

⁸Department of Gastroenterology and Hepatology Amsterdam University Medical Centers, Amsterdam, The Netherlands
Jean-Marc Dumonceau

¹⁸Gedyt Endoscopy Center, Buenos Aires, Argentina

Abstract

Main Recommendations

ESGE recommends a low fiber diet on the day preceding colonoscopy.

Strong recommendation, moderate quality evidence.

ESGE recommends the use of enhanced instructions for bowel preparation.

Strong recommendation, moderate quality evidence.

ESGE suggests adding oral simethicone to bowel preparation.

Weak recommendation, moderate quality evidence.

ESGE recommends split-dose bowel preparation for elective colonoscopy.

Strong recommendation, high quality evidence.

ESGE recommends, for patients undergoing afternoon colonoscopy, a same-day bowel preparation as an acceptable alternative to split dosing.

Strong recommendation, high quality evidence.

ESGE recommends to start the last dose of bowel preparation within 5 hours of colonoscopy, and to complete it at least 2 hours before the beginning of the procedure.

Strong recommendation, moderate quality evidence.

ESGE recommends the use of high volume or low volume PEG-based regimens as well as that of non-PEG-based agents that have been clinically validated for routine bowel preparation. In patients at risk for hydroelectrolyte disturbances, the choice of laxative should be individualized.
Strong recommendation, moderate quality evidence.

Full Text

References

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