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Bowel Cleansing

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Recommendations Salvage Options for Inadequate Preparation ➤ Large-volume enemas can be attempted for patients who, presenting on the day of colonoscopy, report brown effluent despite compliance with the prescribed colon-cleansing regimen. (Weak; Very Low Quality of Evidence) ➤ Through-the-scope enema with completion colonoscopy on the same day can be considered, especially for those patients who receive propofol sedation. (Weak; Very Low Quality of Evidence) ➤ Waking the patient entirely from sedation and continuing with further oral ingestion of cathartic with same-day or next-day colonoscopy has been associated with better outcomes than delayed colonoscopy. (Weak; Low Quality of Evidence) Evaluation Table 1. Aronchick Bowel Preparation Scale Excellent Small volume of clear liquid or >95% of surface seen Good Large volume of clear liquid covering 5%–25% of the surface but >90% of the surface seen Fair Some semisolid stool that could be suctioned or washed away but >90% of the surface seen Poor Semisolid stool that could not be suctioned or washed away and <90% of the surface seen Inadequate Re-preparation needed

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