Colonoscopy preparations: Clearing things up

摘要

Cleansing the colon for modern medical interventions has long been an essential part of most colonic imaging procedures including colonoscopy. Early regimens were designed for radiology imaging and involved as much as 12 L of lavage solution, often in combination with enemas and laxatives and frequently complicated by fluid and electrolyte disorders not to mention patient misery. The largest innovation came in 1980 with the development of an oral solution composed of polyethylene glycol and balancing electrolytes solution (PEG-ES).1 It was devised to minimize fluid and electrolyte shifts and required a relatively paltry 4 L. For the ensuing decades, this PEG-ES and its variations created primarily to improve palatability have been the workhorse, or "old faithful," for bowel preparation. It is both friend (eg, creating reliable cleansing of the colon) and foe (eg, midnight calls with vomiting and discomfort) of physicians and patients alike.