Bowel preparation for colonoscopy: importance of adequate hydration

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Alimentary Pharmacology & Therapeutics

OnlineAccepted Articles

To cite this article: G. R. LICHTENSTEIN, L. B. COHEN, J. URIBARRI Bowel preparation for colonoscopy: importance of adequate hydration Alimentary Pharmacology & Therapeutics (OnlineAccepted Articles). doi:10.1111/j.1365-2036.2007.03406.x

Bowel preparation for colonoscopy: importance of adequate hydration

G. R. LICHTENSTEIN**Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, PA, USA, L. B. COHEN††Department of Medicine (Gastroenterology), Mount Sinai School of Medicine, New York, NY, USA & J. URIBARRI‡‡Department of Medicine (Nephrology), Mount Sinai School of Medicine, New York, NY, USA

*Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, PA, USA; †Department of Medicine (Gastroenterology), Mount Sinai School of Medicine, New York, NY, USA; ‡Department of Medicine (Nephrology), Mount Sinai School of Medicine, New York, NY, USA

Correspondence toG. R. LichtensteinHospital of the University of PennsylvaniaGastroenterology DivisionUniversity of Pennsylvania School of MedicineDepartment of Medicine3400 Spruce St3rd Floor Ravdin BuildingPhiladelphia, PA 19104-4283Email: grl@...Phone: or Fax:

SUMMARY

Background

Patient compliance with screening recommendations for colorectal cancer remains low, despite a 90% survival rate achieved with early detection. Bowel preparation is a major deterrent for patients undergoing screening colonoscopy. More than half of patients taking polyethylene glycol electrolyte lavage solution and sodium phosphate (NaP) preparations experience adverse events such as nausea and abdominal pain. Many adverse events may be associated with dehydration, including rare reports of renal toxicity in patients taking NaP products. Addressing dehydration-related safety issues through patient screening and education may improve acceptance of bowel preparations, promote compliance, and increase the likelihood of a successful procedure.

Aim

We review evidence that safety issues associated with bowel preparation are generally related to inadequate hydration.

Results

Dehydration-related complications may be avoided through proper patient screening; for example, renal function and comorbid conditions should be considered when choosing an appropriate bowel preparation. In addition, patient education regarding the importance of maintaining adequate hydration before, during, and after bowel preparation may promote compliance with fluid volume recommendations and reduce the risk of dehydration-related adverse events.

Conclusions

Proper patient screening and rigorous attention by patients and healthcare providers to hydration during bowel preparation may provide a safer, more effective screening colonoscopy.