Differences in Patient Preference/ Willingness to Repeat
Comparisons
➤ Split-dose bowel cleansing is associated with greater willingness to
repeat regimen compared with the day before regimen. (Strong; High
Quality of Evidence)
➤ The use of low-volume bowel cleansing agents is associated with greater
willingness to undergo a repeat colonoscopy. (Strong; High Quality of
Evidence)
Selection of Bowel Preparation in Specific Populations
➤ There is insufficient evidence to recommend specific bowel preparation
regimens for elderly persons. However, we recommend that NaP
preparations be avoided in this population. (Strong; Low Quality of
Evidence)
➤ There is insufficient evidence to recommend specific bowel preparation
regimens for children and adolescents undergoing colonoscopy.
However, we recommend that NaP preparations should not be used
in children younger than age 12 or in those with risk factors for
complications from this medication. (Strong; Very Low Quality of
Evidence)
➤ NaP should be avoided in patients with known or suspected inflammatory
bowel disease. (Weak; Very Low Quality of Evidence)
➤ Additional bowel purgatives should be considered in patients with risk
factors for inadequate preparation (eg, patients with a prior inadequate
preparation, history of constipation, use of opioids or other constipating
medications, prior colon resection, diabetes mellitus, or spinal cord
injury) (Weak; Low Quality of Evidence)
• Note: A detailed discussion of patient factors that predict inadequate preparation
is presented in Appendix C of the full text guideline ( Johnson DA et al.
Gastroenterolog y 2014;147:903–924).
➤ Low-volume preparations or extended time delivery for high-volume
preparations are recommended for patients after bariatric surgery.
(Weak; Very Low Quality of Evidence)
➤ Tap water enemas should be used to prepare the colon for sigmoidoscopy
in pregnant women. (Strong; Very Low Quality of Evidence)
➤ There is insufficient evidence to recommend specific regimens for
persons with a history of spinal cord injury; additional bowel purgatives
should be considered. (Weak; Very Low Quality of Evidence)
