An adequate bowel preparation is essential for a successful colonoscopy, in particular, in the setting
of colorectal cancer screening. However, up to one-quarter of colonoscopies are associated with inadequate
bowel preparation, which may result in reduced polyp and adenoma detection rates, prolonged procedural time,
and an increased likelihood of repeat the procedure.
The ideal intestinal preparation should provide an optimal observation of the mucosa (at least > 90% of the visible
surface), with adequate acceptability and safety for the patient.
With this premise, a very low-volume 1 L PEG-ASC solution (Plenvu; Norgine, Harefield, United Kingdom)
has been recently introduced to improve patients’ experience in colonoscopy by reducing the total intake of
liquids to be consumed. This could represent a valid option for bowel cleansing, considering CRC screening
and surveillance programs, improving both the quality of the examination and the patients’ compliance.
Nevertheless, it must be emphasized that a “one size fits all” preparation strategy is not feasible and that a bowel
preparation regime must always be selected and tailored by the clinician for each patient, evaluating the best
options on a case by case basis.
This narrative review aims to sum up the evidence regarding new bowel preparation regimens in order to help
clinicians to tailor the best choice for patients undergoing colonoscopy.