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

C. Hassan; M. Bretthauer; M. F. Kaminski; M. Polkowski; B. Rembacken; B. Saunders; R. Benamouzig; O. Holme; S. Green; T. Kuiper; R. Marmo; M. Omar; L. Petruzziello; C. Spada; A. Zullo; J. M. Dumonceau

doi:10.1055/s-0032-1326186

Endoscopy, Inhaltsverzeichnis

Endoscopy 2013; 45(02): 142-155
DOI: 10.1055/s-0032-1326186

Guideline

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

Authors

C. Hassan

¹Digestive Endoscopy Unit, Catholic University, Rome, Italy
M. Bretthauer

²Department of Health Economy and Health Management, University of Oslo and Department of Transplantation Medicine, Gastroenterology Unit, Oslo University Hospital, Oslo, Norway
M. F. Kaminski

³Department of Gastroenterology and Hepatology, Medical Centre for Postgraduate Education, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
M. Polkowski

³Department of Gastroenterology and Hepatology, Medical Centre for Postgraduate Education, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
B. Rembacken

⁴Centre for Digestive Diseases, The General Infirmary, Leeds, UK
B. Saunders

⁵Wolfson Unit for Endoscopy, St Mark’s Hospital, Imperial College London, UK
R. Benamouzig

⁶Department of Gastroenterology, Avicenne Hospital, Paris, France
O. Holme

⁷Department of Gastroenterology, Sorlandet Hospital Kristiansand, Norway
S. Green

⁵Wolfson Unit for Endoscopy, St Mark’s Hospital, Imperial College London, UK
T. Kuiper

⁸Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
R. Marmo

⁹Division of Gastroenterology, L. Curto Hospital, Polla, Sant’Arsenio, Italy
M. Omar

¹⁰Gastroenterology Unit, New Mowasat Hospital, Salmiya, Kuwait
L. Petruzziello

¹Digestive Endoscopy Unit, Catholic University, Rome, Italy
C. Spada

¹Digestive Endoscopy Unit, Catholic University, Rome, Italy
A. Zullo

¹¹Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy
J. M. Dumonceau

¹²Service of Gastroenterology and Hepatology, Geneva University Hospitals, Geneva, Switzerland

Abstract

Background and aim: This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the choice amongst regimens available for cleansing the colon in preparation for colonoscopy.

Methods: This Guideline is based on a targeted literature search to evaluate the evidence supporting the use of bowel preparation for colonoscopy. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendation and the quality of evidence.

Results: The main recommendations are as follows. (1) The ESGE recommends a low-fiber diet on the day preceding colonoscopy (weak recommendation, moderate quality evidence). (2) The ESGE recommends a split regimen of 4 L of polyethylene glycol (PEG) solution (or a same-day regimen in the case of afternoon colonoscopy) for routine bowel preparation. A split regimen (or same-day regimen in the case of afternoon colonoscopy) of 2 L PEG plus ascorbate or of sodium picosulphate plus magnesium citrate may be valid alternatives, in particular for elective outpatient colonoscopy (strong recommendation, high quality evidence). In patients with renal failure, PEG is the only recommended bowel preparation. The delay between the last dose of bowel preparation and colonoscopy should be minimized and no longer than 4 hours (strong recommendation, moderate quality evidence). (3) The ESGE advises against the routine use of sodium phosphate for bowel preparation because of safety concerns (strong recommendation, low quality evidence).

Keywords

bowel preparation - colonoscopy - PEG - sodium phosphate - diet, colorectal cancer screening - inflammatory bowel disease - magnesium citrate - sodium picosulphate

Volltext

Referenzen

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