Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2019

Abstract

ESGE recommends a low fiber diet on the day preceding colonoscopy.Strong recommendation, moderate quality evidence.ESGE recommends the use of enhanced instructions for bowel preparation.Strong recommendation, moderate quality evidence.ESGE suggests adding oral simethicone to bowel preparation.Weak recommendation, moderate quality evidence.ESGE recommends split-dose bowel preparation for elective colonoscopy.Strong recommendation, high quality evidence.ESGE recommends, for patients undergoing afternoon colonoscopy, a same-day bowel preparation as an acceptable alternative to split dosing.Strong recommendation, high quality evidence.ESGE recommends to start the last dose of bowel preparation within 5 hours of colonoscopy, and to complete it at least 2 hours before the beginning of the procedure.Strong recommendation, moderate quality evidence.ESGE recommends the use of high volume or low volume PEG-based regimens as well as that of non-PEG-based agents that have been clinically validated for routine bowel preparation. In patients at risk for hydroelectrolyte disturbances, the choice of laxative should be individualized.Strong recommendation, moderate quality evidence.

Conflict of interest statement

R. Benamouzig has provided consultancy to Alfasigma. R. Bisschops has received speaker’s fees from Norgine (1 January 2017 to present); he is Co-Editor of Endoscopy. E. Dekker is Co-Editor of Endoscopy. M. Dinis-Ribeiro is Co-Editor-in-Chief of Endoscopy. J. East received a speaker fee from Falk (January 2018); his department received support from Boston Scientific (March 2018 to March 2019). I. Gralnek declares consultancy, MAB, and share ownership in Motus GI (2014 to present). C. Hassan provides consultancy to Norgine; his department receives support from Alfasigma. R. Jover has received travel grants from Norgine (2015 to 2019); he has provided advisory services to Norgine (2015 to 2019), Alfasigma (2017 to 2018), GI Supply (2018 to 2019), and CPP Pharmaceuticals (2019); his department has received research grants from MSD (2010 to 2019). M.F. Kaminski has provided speaking and teaching services to Olympus, Alfasigma, and Norgine (2017 to present) and Fujinon (2018 to present), consultancy to Olympus (2017 to present), and advisory services to Alfasigma (2017 to present). M. Pellisé has received consultancy fees from Norgine Iberia (2012 to 2017, 2019 to present), and speaker’s fees from Casen Recordati (2018) and Olympus (2017); her department has been loaned equipment from Fujifilm (2017 to present); she is on the Endoscopy Board. F. Radaelli has received consultancy fees from Norgine (January 2018 to December 2018). C. Spada has received consultancy fees from Norgina and Alfasigma (2016 to 2019). J.E. van Hooft has received lecture fees from Medtronics (2014 to 2015) and Cook Medical (2019), and consultancy fees from Boston Scientific (2014 to 2017); her department has received research grants from Cook Medical (2014 to 2018) and Abbott (2014 to 2017). H. Awadie, M. Bretthauer, J.-M. Dumonceau, M. Ferlitsch, L. Frazzoni, L. Fuccio, C. Mangas-Sanjuan, K. Triantafyllou, and G. Vanella have no competing interests.

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