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World J Gastroenterol. Jan 14, 2013; 19(2): 155-157
Published online Jan 14, 2013. doi: 10.3748/wjg.v19.i2.155
Bowel preparation prior to colonoscopy: A continual search for excellence
Matthew L Bechtold, Abhishek Choudhary
Matthew L Bechtold, Abhishek Choudhary, Division of Gastroenterology, University of Missouri, Columbia, MO 65201, United States
Matthew L Bechtold, Division of Gastroenterology and Hepatology, University of Missouri Health Sciences Center, Five Hospital Drive, Columbia, MO 65212, United States
Author contributions: Bechtold ML wrote the manuscript; Choudhary A discussed the subject and provided critical revisions to the manuscript; both authors approved the final version of the manuscript.
Correspondence to: Matthew L Bechtold, MD, FACG, Division of Gastroenterology and Hepatology, University of Missouri Health Sciences Center, Five Hospital Drive, Columbia, MO 65212, United States. bechtoldm@health.missouri.edu
Telephone: +1-57-38821013 Fax: +1-57-38844595
Received: October 12, 2012
Revised: November 15, 2012
Accepted: December 20, 2012
Published online: January 14, 2013
Processing time: 101 Days and 22.1 Hours
Abstract

Bowel preparation prior to colonoscopy is essential to maximize the benefits of colonoscopy. Numerous bowel preparations have been studied, ranging from 4 L polyethylene glycol (PEG) to split-dose regimens to 2 L PEG with an adjunct laxative (senna, bisacodyl, ascorbic acid). Due to the large volume of PEG required for adequate bowel preparation, many studies have focused on reducing this large volume to only 2 L PEG with the addition of an adjunct. Recently, a randomized controlled trial by Tajika et al showed that the addition of mosapride to only 1.5 L PEG was non-inferior to mosapride and 2 L PEG for bowel cleansing but did provide improvements in patient tolerance. This study offers yet another potential bowel preparation for patients undergoing colonoscopy and may trigger further studies with 1.5 L PEG with an adjunct. In this letter, we discuss the current state of bowel preparation prior to colonoscopy and offer information to guide clinicians on choosing the appropriate bowel preparation for their patients.

Keywords: Colonoscopy; Polyethylene glycol; Mosapride; Bowel preparation