As the leading gastrointestinal procedure performed in the United States, colonoscopy is an important tool for colorectal cancer screening, post polypectomy surveillance, guidance in management of inflammatory bowel disease, and diagnosis of symptoms.
High-quality colonoscopy depends on several factors, including cecal intubation and adequate inspection of the mucosa for adenomas and other pathology, which are dependent on adequate withdrawal time and bowel preparation quality. Current quality indicators recommend that gastroenterologists should strive for adequate bowel preparation in greater than 85% of exams.
However, of the more than 15 million colonoscopies performed annually, approximately 20% to 25% involve inadequate preparation, which has consequences for both patients and the healthcare system. Patients may suffer from increased pain, missed adenomas, subsequent cancers, repeat colonoscopies with associated missed days of work and lost wages, and increased complications. System implications include increased intra-procedural time,4 reduced ability to perform other procedures, and increased costs.