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Splitting doses: A good strategy for colonoscopy preparation?By Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/colonoscopy-preparation/AN02198
- With Mayo Clinic gastroenterologist
Michael F. Picco, M.D.read biographyclose window
Michael F. Picco, M.D.Michael F. Picco, M.D.
Dr. Michael Picco has been with Mayo Clinic since 1999. He is board certified in internal medicine and gastroenterology. Dr. Picco is an assistant professor of medicine at College of Medicine, Mayo Clinic, and a consultant in gastroenterology at Mayo Clinic in Florida.
He has authored numerous publications in the area of gastroenterology, including original research, editorials and textbook chapters. He works with a team of gastroenterologists that takes care of complex gastrointestinal conditions and has a particular interest in diarrheal illnesses and inflammatory bowel diseases (ulcerative colitis and Crohn's disease). He is also active in medical education in training new gastroenterologist and internists.
"Mayo Clinic's website is an invaluable resource for patients and their families," Dr. Picco said. "Informed patients are better able to participate in their own health care. A patient's participation is vital to the treatment of his or her disease. I hope to assist in helping patients understand their digestive problems and current treatments that are offered. This will allow for better communication between patients, their physicians and other health care professionals."
Dr. Picco serves as a reviewer of new research for several medical journals in the area of gastroenterology and is an active member of the American Gastroenterological Association, American College of Gastroenterology and the Crohn's & Colitis Foundation of America. He serves on numerous committees that address physician training, research and clinical practice in gastroenterology, both at Mayo Clinic and at the national level.
"Patients need to know about their disease, what to expect, the latest treatments and side effects so that they can make informed decisions about their health care. Gastrointestinal disease affects not only patients but also their families. My goal is to assure that our website provides accurate, reliable information and resources for patients. We must always provide the latest, most cutting-edge information to assist patients in dealing with their medical problems," Dr. Picco said.
- Splitting doses: A good strategy for colonoscopy preparation?
- Colon cancer screening: At what age can you stop?
Splitting doses: A good strategy for colonoscopy preparation?
My doctor had me take bowel cleansing liquid the night before my colonoscopy and then the morning of. Is this a good colonoscopy preparation?
from Michael F. Picco, M.D.
Cleaning as much waste material as possible from your large intestine (colon) is crucial to a successful colonoscopy exam. Poor colonoscopy preparation can keep your doctor from finding polyps, tumors and other problems. It also increases the length of the exam and the risk of complications. In many cases, the exam has to be redone.
The biggest reason for poor colonoscopy preparation is people's distaste for having to drink large quantities of bowel cleaning solution. The most common colonoscopy preparation calls for drinking 1 gallon (4 liters) of a polyethylene glycol solution. Some studies have shown that more than a third of people don't complete the full preparation.
To make bowel preparation more tolerable, many doctors recommend splitting the dose of bowel preparation. Take 3 liters the night before the exam, and the remainder in the morning before the test. This regimen may not be possible if your colonoscopy is scheduled for early in the morning; you should consume the morning dose four to six hours prior to the procedure.
Studies have shown that the split-dose approach not only is more tolerable, but also does a better job of cleaning the colon. Better cleaning will lead to better results. One study found that doctors detected more common benign tumors (adenomas) in people who prepared with split doses than in people who prepared with single doses.
Ask your doctor about split-dose preparation for your next colonoscopy.Next question
Colon cancer screening: At what age can you stop?
- A-Rahim YI, et al. Bowel preparation for flexible sigmoidoscopy and colonoscopy. http://www.uptodate.com/index. Accessed Jan. 10, 2013.
- Kilgore TW, et al. Bowel preparation with split-dose polyethylene glycol before colonoscopy: A meta-analysis of randomized controlled trials. Gastrointestinal Endoscopy. 2011;73:1240.
- Enestvedt BK, et al. 4-Liter split-dose polyethylene glycol is superior to other bowel preparations, based on systematic review and meta-analysis. Clinical Gastroenterology and Hepatology. 2012;10:1225.
- Gurudu SR, et al. Increased adenoma detection rate with system-wide implementation of a split-dose preparation for colonoscopy. Gastrointestinal Endoscopy. 2012;76:603.
- Lee L, et al. Overview of colonoscopy in adults. http://www.uptodate.com/index. Accessed Jan. 14, 2013.