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Consensus guidelines for the use of bowel preparation prior to colonic diagnostic procedures: colonoscopy and small bowel video capsule endoscopy

Mathus-Vliegen, Elisabeth ; Pellise, Maria ; Heresbach, Denis ; Fischbach, Wolfgang ; Dixon, Tricia ; Belsey, Jonathan ; Parente, Fabrizio ; Rio-Tinto, Ricardo ; Brown, Alistair and Toth, Ervin LU , et al. (2013) In Current Medical Research and Opinion 29(8). p.931-945
Abstract
Background: Adequate bowel preparation prior to colonic diagnostic procedures is essential to ensure adequate visualisation. Scope: This consensus aims to provide guidance as to the appropriate use of bowel preparation for a range of defined clinical circumstances. A consensus group from across Europe was convened and met to discuss appropriate bowel preparation. The use of polyethylene glycol (PEG), sodium picosulphate and sodium phosphate (NaP), together with other agents, prokinetics and simethicone, in colonoscopy and small bowel video capsule endoscopy were considered. A systematic review of the literature was carried out and additional unpublished data was obtained from the members of the consensus group where required.... (More)
Background: Adequate bowel preparation prior to colonic diagnostic procedures is essential to ensure adequate visualisation. Scope: This consensus aims to provide guidance as to the appropriate use of bowel preparation for a range of defined clinical circumstances. A consensus group from across Europe was convened and met to discuss appropriate bowel preparation. The use of polyethylene glycol (PEG), sodium picosulphate and sodium phosphate (NaP), together with other agents, prokinetics and simethicone, in colonoscopy and small bowel video capsule endoscopy were considered. A systematic review of the literature was carried out and additional unpublished data was obtained from the members of the consensus group where required. Recommendations were graded according to the level of evidence. Findings: PEG-based regimens are recommended first line for both procedures, since their use is supported by good efficacy and safety data. Sodium-picosulphate-based regimens are recommended second line as their cleansing efficacy appears less than PEG-based regimens. NaP is not recommended for bowel cleansing due to the potential for renal damage and other adverse events. However, the use of NaP is acceptable in patients in whom PEG or sodium picosulphate is ineffective or not tolerated. NaP should not be used in patients with chronic kidney disease, pre-existing electrolyte disturbances, congestive heart failure, cirrhosis or a history of hypertension. The timing of the dose, dietary restrictions, use in special patient groups and recording of the quality of bowel preparation are also considered for patients undergoing colonoscopy. During the development of the guidelines the European Society of Gastrointestinal Endoscopy (ESGE) issued guidance on bowel preparation for colonoscopy. The ESGE guidelines and these consensus guidelines share many recommendations; differences between the guidelines are reviewed. Conclusion: The use of bowel preparation should be tailored to the individual patient and their specific clinical circumstances. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bowel preparation, Colonoscopy, Guidelines, Video capsule endoscopy
in
Current Medical Research and Opinion
volume
29
issue
8
pages
931 - 945
publisher
LibraPharm
external identifiers
  • wos:000321909100007
  • scopus:84880466670
ISSN
1473-4877
DOI
10.1185/03007995.2013.803055
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200)
id
f39f89a9-b190-4c6d-805c-3ae5d03dd87d (old id 3973283)
date added to LUP
2016-04-01 10:59:37
date last changed
2022-04-04 23:20:46
@article{f39f89a9-b190-4c6d-805c-3ae5d03dd87d,
  abstract     = {{Background: Adequate bowel preparation prior to colonic diagnostic procedures is essential to ensure adequate visualisation. Scope: This consensus aims to provide guidance as to the appropriate use of bowel preparation for a range of defined clinical circumstances. A consensus group from across Europe was convened and met to discuss appropriate bowel preparation. The use of polyethylene glycol (PEG), sodium picosulphate and sodium phosphate (NaP), together with other agents, prokinetics and simethicone, in colonoscopy and small bowel video capsule endoscopy were considered. A systematic review of the literature was carried out and additional unpublished data was obtained from the members of the consensus group where required. Recommendations were graded according to the level of evidence. Findings: PEG-based regimens are recommended first line for both procedures, since their use is supported by good efficacy and safety data. Sodium-picosulphate-based regimens are recommended second line as their cleansing efficacy appears less than PEG-based regimens. NaP is not recommended for bowel cleansing due to the potential for renal damage and other adverse events. However, the use of NaP is acceptable in patients in whom PEG or sodium picosulphate is ineffective or not tolerated. NaP should not be used in patients with chronic kidney disease, pre-existing electrolyte disturbances, congestive heart failure, cirrhosis or a history of hypertension. The timing of the dose, dietary restrictions, use in special patient groups and recording of the quality of bowel preparation are also considered for patients undergoing colonoscopy. During the development of the guidelines the European Society of Gastrointestinal Endoscopy (ESGE) issued guidance on bowel preparation for colonoscopy. The ESGE guidelines and these consensus guidelines share many recommendations; differences between the guidelines are reviewed. Conclusion: The use of bowel preparation should be tailored to the individual patient and their specific clinical circumstances.}},
  author       = {{Mathus-Vliegen, Elisabeth and Pellise, Maria and Heresbach, Denis and Fischbach, Wolfgang and Dixon, Tricia and Belsey, Jonathan and Parente, Fabrizio and Rio-Tinto, Ricardo and Brown, Alistair and Toth, Ervin and Crosta, Cristiano and Layer, Peter and Epstein, Owen and Boustiere, Christian}},
  issn         = {{1473-4877}},
  keywords     = {{Bowel preparation; Colonoscopy; Guidelines; Video capsule endoscopy}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{931--945}},
  publisher    = {{LibraPharm}},
  series       = {{Current Medical Research and Opinion}},
  title        = {{Consensus guidelines for the use of bowel preparation prior to colonic diagnostic procedures: colonoscopy and small bowel video capsule endoscopy}},
  url          = {{http://dx.doi.org/10.1185/03007995.2013.803055}},
  doi          = {{10.1185/03007995.2013.803055}},
  volume       = {{29}},
  year         = {{2013}},
}