April 7th, 2009
Our Love-Hate Relationship with Bowel Preps: It’s Time to Split Up!
For the past couple years, my colleagues and I have been bemoaning the state of bowel preps, especially for colonoscopies done in the afternoon. As many as one third of those preps were so poor that we had to tell patients to resume screening at intervals sooner than 7 to 10 years, for fear of missed lesions.
Thinking the problem was mainly related to the delay between the prep and the procedure, we decided this winter to split the dose (half the day before, and half 4 to 5 hours before the procedure) for all bowel preps — a practice that the ACG also now recommends. Lo and behold, the preps in our clinic are now uniformly good to excellent, regardless of whether the case is seen in the morning or afternoon.
What is your experience with bowel preps and split dosing? Have you had similar success or encountered any obstacles in implementation?