Jacobson Brian C, Anderson Joseph C, Burke Carol A, Dominitz Jason A, Gross Seth A, May Folasade P, Patel Swati G, Shaukat Aasma, Robertson Douglas J
Department of Medicine, Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
VA Medical Center, White River Junction, Vermont; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; University of Connecticut School of Medicine, Farmington, Connecticut.
Gastroenterology. 2025 Apr;168(4):798-829. doi: 10.1053/j.gastro.2025.02.002. Epub 2025 Mar 4.
This document is an update to the 2014 recommendations for optimizing the adequacy of bowel cleansing for colonoscopy from the US Multi-Society Task Force on Colorectal Cancer, which represents the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy. The US Multi-Society Task Force developed consensus statements and key clinical concepts addressing important aspects of bowel preparation for colonoscopy. The majority of consensus statements focus on individuals at average risk for inadequate bowel preparation. However, statements addressing individuals at risk for inadequate bowel preparation quality are also provided. The quality of a bowel preparation is defined as adequate when standard screening or surveillance intervals can be assigned based on the findings of the colonoscopy. We recommend the use of a split-dose bowel preparation regimen and suggest that a 2 L regimen may be sufficient. A same-day regimen is recommended as an acceptable alternative for individuals undergoing afternoon colonoscopy, but we suggest that a same-day regimen is an inferior alternative for individuals undergoing morning colonoscopy. We recommend limiting dietary restrictions to the day before a colonoscopy, relying on either clear liquids or low-fiber/low-residue diets for the early and midday meals. We suggest the adjunctive use of oral simethicone for bowel preparation before colonoscopy. Routine tracking of the rate of adequate bowel preparations at the level of individual endoscopists and at the level of the endoscopy unit is also recommended, with a target of >90% for both rates.
本文档是美国结直肠癌多学会特别工作组对2014年结肠镜检查肠道准备充分性优化建议的更新，该工作组代表美国胃肠病学会和美国胃肠内镜学会。美国多学会特别工作组制定了共识声明和关键临床概念，涉及结肠镜检查肠道准备的重要方面。大多数共识声明关注肠道准备不足风险平均的个体。不过，也提供了针对肠道准备质量有风险个体的声明。当基于结肠镜检查结果能够确定标准筛查或监测间隔时，肠道准备质量被定义为充分。我们推荐采用分剂量肠道准备方案，并提示2升方案可能就足够了。对于接受下午结肠镜检查的个体，推荐采用当日方案作为可接受的替代方案，但我们提示对于接受上午结肠镜检查的个体，当日方案是较差的替代方案。我们建议将饮食限制限于结肠镜检查前一天，早餐和午餐依靠清流食或低纤维/低残渣饮食。我们建议在结肠镜检查前肠道准备时辅助使用口服西甲硅油。还建议在内镜医师个体层面和内镜检查单元层面常规追踪充分肠道准备率，两个层面的目标均为>90%。
