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

Colonoscopy is the current standard method for evaluating the colon. Recent surveys have shown that the proportion of individuals aged 50 years or older who have undergone colonoscopy within the last 10 years is growing and currently ranges from 6%–25% in various European countries to 62% in the United States [1, 2]. Bowel preparation for colonoscopy is a complex undertaking, involving diet modifications and laxative choice according to patient needs. An adequate level of cleansing is critical for the efficacy of colonoscopy. Two key quality indicators of colonoscopy, cecal intubation rate and polyp detection rate, are associated with the quality of bowel cleansing [3,4]. An inadequate level of bowel cleansing also results in further costs as the examination has to be re-scheduled or alternative investigations have to be organized [5]. Furthermore, the discomfort and inconvenience of bowel preparation may affect the acceptability and uptake of colonoscopy in screening programs [6]. The aim of this evidence-based and consensusbased Guideline commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to provide caregivers with a comprehensive review of the various regimens available and with practical advice for bowel preparation before colonoscopy.