What is the best bowel preparation for screening colonoscopies?
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What is the best bowel preparation for screening colonoscopies? Evidence-based answer: For adult patients (free of renal impairment, symptomatic congestive heart failure, known coronary artery disease, or ascites), oral sodium phosphate (NaP) is superior to both polyethylene glycol (PEG) and sodium picosulfate (SPS) for bowel cleansing and superior to PEG for bowel prep completion (strength of recommendation [SOR]: A, high-quality meta-analysis). Overall, no difference was noted in adverse effects between NaP and PEG; however, dizziness is more likely with NaP and abdominal pain is more likely with PEG (SOR: A, high-quality meta-analysis). NaP is more likely to result in serum derangements of potassium, phosphate, and calcium than PEG (SOR: A, multiple RCTs). PEG is the preferred bowel prep agent for patients with renal dysfunction, cardiac disease, or electrolyte abnormalities (SOR: C, expert opinion).
Evidence Based Practice 17(5): 01-02