Am J Gastroenterol

New guidelines aim to improve bowel preparation for colonoscopy

May 12, 2025

Guideline overview: This document updates the 2014 recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer, representing the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy. The task force developed consensus statements and key clinical concepts to address important aspects of bowel preparation for colonoscopy.

Key recommendations:

• Focus on individuals at average risk for inadequate bowel preparation, with additional statements for those at higher risk.
• Define adequate bowel preparation as one that allows standard screening or surveillance intervals based on colonoscopy findings.
• Recommend split-dose bowel preparation regimen; a 2-L regimen may be sufficient.
• Recommend same-day regimen as an acceptable alternative for afternoon colonoscopies; experts suggest it's inferior for morning colonoscopies.
• Limit dietary restrictions to the day before colonoscopy, using clear liquids or low-fiber/low-residue diets for early and midday meals.
• Suggest adjunctive use of oral simethicone for bowel preparation.
• Recommend routine tracking of adequate bowel preparation rates at individual endoscopist and endoscopy unit levels, targeting >90% for both.

Clinical impact: These guidelines aim to standardize bowel preparation practices, thereby improving the quality of colonoscopies and increasing the detection rates of precancerous lesions. By following these recommendations, clinicians can enhance patient compliance and preparation adequacy, ultimately leading to better clinical outcomes in colorectal cancer screening and surveillance.

Source:

Jacobson BC, et al. (2025, April 1). Am J Gasteroenterol. Optimizing Bowel Preparation Quality for Colonoscopy: Consensus Recommendations by the US Multi-Society Task Force on Colorectal Cancer. https://pubmed.ncbi.nlm.nih.gov/40035345/