Endoscopy 2019; 51(08): 775-794
DOI: 10.1055/a-0959-0505
Guideline
© Georg Thieme Verlag KG Stuttgart · New York

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

Cesare Hassan
 1  Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy
,
James East
 2  Translational Gastroenterology Unit, John Radcliffe Hospital, University of Oxford, and Oxford NIHR Biomedical Research Centre, Oxford, United Kingdom
,
Franco Radaelli
 3  Valduce Hospital, Como, Italy
,
Cristiano Spada
 4  Digestive Endoscopy Unit, Fondazione Poliambulanza, Brescia, Italy
,
Robert Benamouzig
 5  Gastroenterology Unit, Bobigny, France
,
Raf Bisschops
 6  University Hospitals Leuven, KU Leuven, Department of Gastroenterology and Hepatology
,
Michael Bretthauer
 7  Institute of Health and Society, University of Oslo Department of Transplantation Medicine, Oslo University Hospital, Norway
,
E. Dekker
 8  Department of Gastroenterology and Hepatology Amsterdam University Medical Centers, Amsterdam, The Netherlands
,
Mario Dinis-Ribeiro
 9  CIDES/CINTESIS, Faculty of Medicine, University of Porto, Porto, Portugal
,
Monika Ferlitsch
10  Department 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
11  Gastroenterology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
,
Halim Awadie
12  Institute of Gastroenterology and Hepatology Emek Medical Center Afula, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel
,
Ian Gralnek
12  Institute of Gastroenterology and Hepatology Emek Medical Center Afula, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel
,
Rodrigo Jover
13  Servicio de Medicina Digestiva. Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria ISABIAL, Alicante, Spain
,
Michal F. Kaminski
14  Department of Gastroenterology, Hepatology and Oncology, Center for Postgraduate Medical Education, Warsaw, Poland
,
Maria Pellisé
15  Gastroenterology 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
16  Ηepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Athens University, Athens Greece
,
Giuseppe Vanella
17  Digestive Disease Unit, Sant'Andrea Hospital, Sapienza University of Rome, Italy
,
Carolina Mangas-Sanjuan
13  Servicio de Medicina Digestiva. Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria ISABIAL, Alicante, Spain
,
Leonardo Frazzoni
11  Gastroenterology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
,
Jeanin E. Van Hooft
 8  Department of Gastroenterology and Hepatology Amsterdam University Medical Centers, Amsterdam, The Netherlands
,
Jean-Marc Dumonceau
18  Gedyt Endoscopy Center, Buenos Aires, Argentina
› Author Affiliations
Further Information

Publication History

Publication Date:
11 July 2019 (eFirst)

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.

Supplementary material