Gastroenterology and Hepatology

Bowel Prep

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All the information provided here including recommendations and suggestions should be treated for informational purposes only and not a coercion to follow.
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Ideal bowel prep should:

Reliably empty the colon

Doesn’t cause gross or histologic alteration of the colonic mucosa

No patient discomfort

No shifts in fluids / electrolytes

Inexpensive

 

Diet restriction: Clear liquids and low residue diet for 1-4 days

 

PREPARATIONS AVAILABLE:

 

PEG:

Nonabsorbable solution.

No food 2 hours prior

240ml every 10 min till rectal output clear or 4 L consumed

<5 hours before procedure is best. >19 hours poor.

Addition of Bisacodyl to 4L PEG is not useful

Preferred in renal, liver, CCF patients

 

Other regimes of PEG:

2-3 L the night before colonoscopy then 1-2 L morning of the procedure

Low volume PEG (2L) in the evening preceeded by 1 day CF with 4 tab Bisacodyl at noon

 

Fleet:

Low volume hyperosmotic solution

Significant fluid and electrolyte shifts

CF 1 day and 45cc 2 times 10-12 hours apart (eg: 6pm and 6am)

 

Tablet NaP

32-40 tablets. (20 tab evening before and 12-20 tab on the day of the procedure, 3-5 hours before procedure)

Taken 4 tab every 15 minutes with 240ml fluids

 

Making sure solutions are consumed:

Mix with flavouring agents

Use Ryle’s Tube

 

Risk of poor prep:

 

Food to avoid: