Superior bowel preparation for afternoon colonoscopy

A recently published article in Am J Gastroenterol July 2010 confirmed our centre’s experience that for patients having an afternoon colonoscopy, a “split bowel prep” is best.

Not only is the bowel preparation superior but patients also found the split prep easier with half taken on the morning of the procedure resulting in less bloating and better sleep quality.

In 2009, the American College of Gastroenterology endorsed "split-prep" as the optimal bowel prep regimen, with half taken evening before and half the morning of the procedure.

One reason why the morning bowel prep results in better cleansing, Dr. Castro said, is that "as the patient finishes drinking the solution, bile starts to accumulate in the colon, staining the bowel so the colonoscopist can see less. The closer the colonoscopy to the time of the prep, the better the visibility is."

Patient questionnaires showed that those in the morning group were 58% less likely to lose sleep (p = 0.038) and 55% less likely to have bloating (p = 0.027) compared with the evening group.

We recommend the split-dose strategy on the morning preceding afternoon colonoscopies.

Am J Gastroenterol. Published online July 6, 2010.