Bowel preparations as quality indicators for colonoscopy

Abstract

Colonoscopy is the principal investigative procedure for colorectal neoplasms because it can detect and remove most precancerous lesions. The effectiveness of colonoscopy depends on the quality of the examination. Bowel preparation is an essential part of high-quality colonoscopies because only an optimal colonic cleansing allows the colonoscopist to clearly view the entire colonic mucosa and to identify any polyps or other lesions. Suboptimal bowel preparation not only prolongs the overall procedure time, decreases the cecal intubation rate, and increases the costs associated with colonoscopy but also increases the risk of missing polyps or adenomas during the colonoscopy. Therefore, a repeat examination or a shorter colonoscopy follow-up interval may be suitable strategies for a patient with suboptimal bowel preparation.

Keywords: Bower preparation; Colonoscopy; Colorectal neoplasm; Quality.

Figure 1

Representative endoscopic image according to the bowel preparation scale. A: Excellent, there are no or minimal solid stool and only small amount of clear fluid that require suctioning; B: Good, it is used to describe no or minimal solid stool with large amounts of clear fluid that require suctioning; C: Fair, it means the presence of semisolid debris that are cleared with difficulty; D: Poor, it is impossible to observe the colonic mucosa because of solid or semisolid stools.