Bowel preparation for colonoscopy

The present book provides an up-to-date extensive review of the literature that should assist clinicians to optimize bowel preparation in their colonoscopy practice. Colonoscopy represents the cornerstone of colorectal cancer (CRC) screening programs, both as a frontline test and as the final common pathway for other screening modalities. The effectiveness of colonoscopy in CRC prevention mostly depends on the quality of the examination (i.e., the accuracy in detecting colorectal neoplasia) and on patient adherence to the procedure itself, which are both largely affected by bowel preparation. Thus, optimizing bowel preparation in terms of efficacy and acceptance plays a key role in increasing the effectiveness of colonoscopy in CRC prevention. Bowel preparation is a complex process, including diet, the choice of cleansing agent, the regimen of administration and patient’s compliance to instructions. In the last 10 years, new evidence has significantly changed many aspects of this process. Besides, there has been a great leap forward in the armamentarium of bowel preps, and now low or very-low volume cleansing agents are increasingly replacing high-volume solutions. The knowledge of all available alternatives, their characteristics, strengths, and weaknesses are critical to tailor the right solution based on the patient’s clinical status, comorbidities, and preference and deliver the best preparation scheme to every patient.