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World J Gastroenterol. Mar 21, 2014; 20(11): 2746-2750
Published online Mar 21, 2014. doi: 10.3748/wjg.v20.i11.2746
Bowel preparations as quality indicators for colonoscopy
Jae Young Jang, Hoon Jai Chun
Jae Young Jang, Hoon Jai Chun, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-701, South Korea
Hoon Jai Chun, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul 136-705, South Korea
Author contributions: Jang JY wrote the paper; Chun HJ designed and edited the paper.
Correspondence to: Hoon Jai Chun, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705, South Korea. drchunhj@chol.com
Telephone: +82-2-9206555 Fax: +82-2-9531943
Received: August 8, 2013
Revised: February 1, 2014
Accepted: February 20, 2014
Published online: March 21, 2014
Abstract

Colonoscopy is the principal investigative procedure for colorectal neoplasms because it can detect and remove most precancerous lesions. The effectiveness of colonoscopy depends on the quality of the examination. Bowel preparation is an essential part of high-quality colonoscopies because only an optimal colonic cleansing allows the colonoscopist to clearly view the entire colonic mucosa and to identify any polyps or other lesions. Suboptimal bowel preparation not only prolongs the overall procedure time, decreases the cecal intubation rate, and increases the costs associated with colonoscopy but also increases the risk of missing polyps or adenomas during the colonoscopy. Therefore, a repeat examination or a shorter colonoscopy follow-up interval may be suitable strategies for a patient with suboptimal bowel preparation.

Keywords: Colonoscopy, Colorectal neoplasm, Bower preparation, Quality

Core tip: Bowel preparation is one of the most frequent reasons why patients object to participating in screening colonoscopies, and inadequate preparation is a major obstacle to achieving a high-quality colonoscopy. Furthermore, the two most important quality indicators of colonoscopy, the adenoma detection rate and cecal intubation rate, are associated with the quality of bowel preparation. Therefore, bowel preparation is critical for high-quality colonoscopies because only optimal colonic cleansing allows the colonoscopist to view clearly the entire colonic mucosa. A greater awareness of the importance of adequate preparation will lead to the improved quality of colonoscopies.