Bowel preparation in diabetic patients undergoing colonoscopy

• Published in: Annals of gastroenterology Vol. 34; no. 3; pp. 310 - 315
• Main Authors: Agha, Osama Qasim, Alsayid, Muhammad, Brown, Michael D
• Format: Journal Article
• Language: English
• Published: Greece Hellenic Society of Gastroenterology 2021
• Subjects: Review; bowel preparation; diabetes mellitus; colorectal cancer; Colonoscopy
• ISSN: 1108-7471; 1792-7463; 1792-7463
• DOI: 10.20524/aog.2021.0599

Diabetes mellitus is a risk factor for poor bowel preparation in patients who undergo colonoscopy, because of their decreased intestinal transit and slow gastric emptying. This might lead to neoplastic or preneoplastic lesions being missed, longer procedural time, a higher risk of procedure-related adverse events, significant cost burden, patient dissatisfaction, and the need for a repeat colonoscopy. Multiple strategies have been suggested to improve bowel preparation in these patients. Proposed pharmacologic strategies include adding magnesium citrate, bisacodyl, lubiprostone or pyridostigmine. Non-pharmacologic strategies include preferential procedure scheduling or using a diabetes-specific preparation protocol. In this article, we present a comprehensive review of the literature and provide specific recommendations to general practitioners and gastroenterologists for improving bowel preparation in patients with diabetes.