A bowel preparation is fundamental before making a colonoscopy, letting us realize a
correct exploration in all the bowel. The main method of cleaning would be fast, safe and
getting a high grade of visualizing to do a quality colonoscopy.
Actually there are a lot of methods or products of cleaning the bowel. A good cleaning
have a lot of successful choosing a good product to do it and having a good diet before
the colonoscopy.
There are a lot of scales about the cleaning in the colonoscopy, having a good bowel
preparation increase the capacity of the detection of polyps, decrease the time of the
colonoscopy and getting better the cost and efficiency.
The colonoscopy plays a crucial role in the screening and treatment of colorectal cancer.
It is an optimal procedure to identify precancerous lesions. polyps and recommended for
screening people with risk factors, such as a family history of polyps or cancer.
Bowel preparation is a crucial aspect in colonoscopy due to its direct relationship with
the quality of the procedure. Many patients find bowel preparation to be the most
uncomfortable part of the examination, so ensuring that it is safe, extremely efficient,
reliable, convenient and tolerable enough to ensure that patients will not be able to
complete it or wish to undergo future procedures, associating this with the bad taste of
the agents used and the adverse events produced.
Ignorance of the importance of adequate bowel preparation and cleansing explains poor
adherence to instructions, and increases the rate of inadequate bowel preparation.
The health team must provide correct and clear information that improves patient
adherence. The importance of compliance with the indications and the impact of adequate
intestinal cleansing on the findings and results of colonoscopy should be emphasized.
The cleaning systems used in colonoscopy must allow more than 90% of the mucosal surface
to be explored. Furthermore, the drugs used must be well tolerated by the patient and not
cause side effects. Therefore, the ideal colonoscopy preparation should combine efficacy,
excellent tolerance, and minimal adverse effects.
The use of oral bowel preparations may induce strong peristalsis, cramps, bloating,
diarrhea and other symptoms. Intolerance to the preparation is common and is usually
associated with the volume of liquid consumed and the taste of the solution.
Polyethyleneglycol (Muvinlax(r) or Nulytely is a non-absorbable electrolyte solution and
does not induce electrolyte mucus secretion or significantly reduce fluid exchange in the
colonic lumen. It has been shown to be non-toxic and can be ingested in large quantities
without dangerous effects. Its use is relatively safe in patients with kidney failure,
cirrhosis or congestive heart failure.
Bowel preparation with polyethyleneglycol represents the most used formula in our
environment. Among the recognized limitations associated with its application are: the
large amount of volume to be ingested (4 L), which makes it impossible to administer it
to elderly people with swallowing difficulties, it is also poorly tolerated by patients
and has been associated with medical complications, among which can be mentioned:
vomiting, abdominal distension, abdominal pain, nausea, Mallory Weiss syndrome,
esophageal perforation, bronchoaspiration, toxic colitis, pancreatitis induced by
polyethyleneglycol.
Lactulose (Duphalac (r)) is a disaccharide, semi-synthetic derivative of lactulose. It is
absorbed and undergoes bacterial action, which causes fermentation, acidifying the
environment and causing acceleration of intestinal transit, stimulating motility. Another
consequence of acidification is the increase in osmotic pressure within the lumen of the
colon, proportional to the dose. Regarding the dose, 120 ml are diluted with juice or
clear water until completing 1000 ml, swallowing the entire volume in 1 hour The
preparation regimen has a significant impact on the quality of intestinal cleansing.
Traditionally, preparation is done one day before a colonoscopy.