Colonoscopy prep
Formal Definition
Bowel preparation required before colonoscopy to achieve adequate visualization of the colonic mucosa; typically involves a low-residue diet the day before followed by a large-volume polyethylene glycol (PEG) solution or split-dose regimen; inadequate prep results in missed polyps and repeat procedures.
How It's Used on the Ward
"Bowel prep" or "they are prepped and ready" — the often-dreaded cleansing process patients undergo the day before colonoscopy.
Example
""Patient is admitted for urgent colonoscopy for lower GI bleed: starting GoLYTELY 4 liters via NGT over 4 hours to prep the colon. Once the effluent is clear, GI will scope. IV fluids running to compensate for prep losses.""
Clinical Context
Outpatient prep: low-fiber diet 2 days before, clear liquids day before, PEG solution (GoLYTELY, MoviPrep) the evening before and/or morning of scope (split-dose preferred for afternoon procedures). Inpatient/urgent prep: PEG via NGT acceptable if patient unable to drink volume. Contraindications: suspected perforation, obstruction, toxic megacolon. Quality metric: Boston Bowel Preparation Scale ≥6 = adequate. Inadequate prep rate is ~25% — a preventable quality issue. Patients on warfarin/anticoagulants: hold before high-risk procedures (polypectomy). Diabetic patients: hold metformin and SGLT2 inhibitors day of procedure.