Preparation of the Gut before Colonoscopy

Summary

The authors summarize in the submitted paper basic knowledge on the preparation of the gutbefore colonoscopic examination, and based on analysis of available studies they try to recommendthe optimal method of preparation. At present two main methods are used. Mostfrequently isomolar solutions are administered which contain non-absorbable molecules ofpolyethylene glycol (PEG) which act as an osmotic agent (Golytely, Nulytely, Fortrans andothers). An alternative is administration of hyperosmolar phosphate solutions (Fleet Phosphosoda;in the Czech Republic prepared magistraliter) which despite better tolerance and a lowercost have some disadvantages as compared with the first type of preparations.The latter includeinadequate quality of preparation in the right part of the colon in some patients, the presenceof bubbles and formation of aphtoid lesions of the intestinal mucosa which may lead to anerroneous diagnosis. The problem with both types of solutions is the unpleasant salty flavour,therefore in some countries flavoured solutions are used. Other less frequently used methodsinclude preparation with other solutions - magnesiumsulphate, castor oil, sennosides.Formerlymannitol or sorbitol solutions were used.To improve the quality and tolerance of the preparationvarious adjuvants are used. Their importance is however not fundamental and they are usedonly in the minority of patients.

Key words:
colonoscopy - preparation before examination of the gut - diagnosis - polyethyleneglycol - phosphate solutions.