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Clin Colon Rectal Surg 2001; 14(4): 309-316
DOI: 10.1055/s-2001-18509
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Bowel Preparation for Colonoscopy

Oded Zmora, Steven D. Wexner
  • Dept. of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL
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Publication History

Publication Date:
19 November 2001 (online)

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ABSTRACT

The large bowel normally contains formed and solid stool, which hampers the performance of a safe and informative lower endoscopy. The aim of mechanical bowel preparation for colonoscopy is to rid the bowel of stool and permit adequate visualization of the entire colonic mucosa. For flexible sigmoidoscopy, which examines only the rectum and distal colon, cleansing of the rectosigmoid only is sufficient. Self-administered phosphate enemas provides adequate preparation in these cases, although several authors have advocated the addition of oral cathartic agents. However, for colonoscopy, a pancolonic mechanical bowel preparation is required. The newest methods of bowel cleansing with polyethylene glycol and sodium phosphate provide a high quality of preparation, with an acceptably low morbidity rate and a high degree of patient satisfaction, in a cost-effective manner. The current data suggest that mechanical bowel preparation with sodium phosphate is better tolerated by the patients and is the most commonly used preparation by colorectal surgeons for both colonoscopy and surgery. Both polyethylene glycol and sodium phosphate are associated with electrolyte and osmolarity imbalances, although greater changes have been found in patients who received sodium phosphate. Thus, in patients with a history of significant renal, heart, or liver disease, polyethylene glycol may be safer.

KEYWORD

Bowel preparation - sodium phosphate - polyethylene glycol - colonoscopy

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