{"title":"Preparación para colonoscopia en 2016: recomendaciones actuales utilizando datos nacionales","authors":"Daniel Ruiz-Romero, Félix Ignacio Téllez-Ávila","doi":"10.1016/j.endomx.2016.06.001","DOIUrl":null,"url":null,"abstract":"<div><p>Colonoscopy is still the method of choice for the prevention and monitoring of colorectal cancer and premalignant lesions. Proper preparation is essential for attaining optimal visualisation and evaluation of the colon mucosa. Although the ideal method of preparing the colon must be safe, well tolerated, inexpensive, and effective, none of the options that we currently have meets all of these features. A low-residue diet is more tolerable and as effective as a diet with liquids only. Within the available solutions, polyethylene glycol (PEG) and the combination of sodium picosulfate<!--> <!-->+<!--> <!-->magnesium oxide<!--> <!-->+<!--> <!-->citric acid (PicoPrep) are the two most commonly used solutions, either alone or combined with other drugs to enhance the quality of the preparation and tolerability. Both are equally effective; however, polyethylene glycol is the only one that can be used in various clinical situations, such as pregnancy, the elderly, dehydration, cirrhosis, heart failure, and kidney failure. On the other hand, although the sodium phosphate solution is better tolerated, it is increasingly being used less because it can cause acute kidney injury and severe electrolyte abnormalities; thus it is no longer recommended for use in all patients. Although there is evidence for the efficacy of loperamide and simethicone as adjuvants to preparation, they are yet not recommended for routine use in the various schemes of bowel cleansing. This article describes the different options for preparation prior to colonoscopy, including diet, solutions, adjuvants, as well as how to properly assess the quality of the preparation.</p></div>","PeriodicalId":100465,"journal":{"name":"Endoscopia","volume":"28 2","pages":"Pages 81-89"},"PeriodicalIF":0.0000,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.endomx.2016.06.001","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endoscopia","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0188989316300252","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
Colonoscopy is still the method of choice for the prevention and monitoring of colorectal cancer and premalignant lesions. Proper preparation is essential for attaining optimal visualisation and evaluation of the colon mucosa. Although the ideal method of preparing the colon must be safe, well tolerated, inexpensive, and effective, none of the options that we currently have meets all of these features. A low-residue diet is more tolerable and as effective as a diet with liquids only. Within the available solutions, polyethylene glycol (PEG) and the combination of sodium picosulfate + magnesium oxide + citric acid (PicoPrep) are the two most commonly used solutions, either alone or combined with other drugs to enhance the quality of the preparation and tolerability. Both are equally effective; however, polyethylene glycol is the only one that can be used in various clinical situations, such as pregnancy, the elderly, dehydration, cirrhosis, heart failure, and kidney failure. On the other hand, although the sodium phosphate solution is better tolerated, it is increasingly being used less because it can cause acute kidney injury and severe electrolyte abnormalities; thus it is no longer recommended for use in all patients. Although there is evidence for the efficacy of loperamide and simethicone as adjuvants to preparation, they are yet not recommended for routine use in the various schemes of bowel cleansing. This article describes the different options for preparation prior to colonoscopy, including diet, solutions, adjuvants, as well as how to properly assess the quality of the preparation.