Review article: Bowel preparation for colonoscopy--the importance of adequate hydration.
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 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 sodium phosphate 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.


OBJECTIVE
To evidence 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.
Lichtenstein
G R
GR
Hospital of the University of Pennsylvania, Gastroenterology Division, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-4283, USA. grl@uphs.upenn.edu
Cohen
L B
LB
Uribarri
J
J
D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy / Q000379:methods*; D004337:Drug Carriers / Q000008:administration & dosage* / Q000009:adverse effects; D004573:Electrolytes / Q000097:blood; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D010710:Phosphates / Q000008:administration & dosage* / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011300:Preoperative Care / Q000379:methods; D014882:Water-Electrolyte Balance
D002400:Cathartics; D004337:Drug Carriers; D004573:Electrolytes; D010710:Phosphates; D011092:Polyethylene Glycols