Preparation for colonoscopy: Recommendations by an expert panel in Italy

Cristiano Spada, Renato Cannizzaro, Maria Antonietta Bianco, Rita Conigliaro, Emilio Di Giulio, Cesare Hassan, Riccardo Marmo, Pietro Occhipinti, Franco Radaelli, Alessandro Repici, Enrico Ricci, Guido Costamagna

Research output: Contribution to journalArticlepeer-review


Background: Despite several guidelines on bowel preparation being available, their applicability in Italy is poorly investigated. Aims: (1) To create expert-based recommendations for the Italian setting based on available international guidelines on bowel preparation for colonoscopy; (2) to assess consensus across the Italian endoscopy community. Methods: The study was conducted in 2 phases: (a) statements formulation, (b) assessment of consensus. For the first phase, 6 topics related to bowel preparation were identified: (1) efficacy/tolerability; (2) timing; (3) assessment of quality of bowel preparation; (4) factors associated with inadequate preparation; (5) patient education and (6) impact of organisational factors. For each topic, statements were produced and voted by a panel of experts. For consensus assessment, the invited participants were asked to rate the statements. The statement achieved a good level of agreement when at least 70% of voters agreed with it. Results: 25 statements were agreed in the first phase. Agreement was not achieved by the endoscopy community for 7 statements, mainly concerning practical aspects (i.e. strategies for management of patients with inadequate preparation, organisational factors). Conclusion: A clinically relevant consensus was achieved on the main topics of bowel preparation, such as the choice of laxative and the time of administration, and it may help to homogenize the colonoscopy practice in Italy. Nevertheless, there are a few country-specific preparation-related issues that need to be addressed.

Original languageEnglish
Pages (from-to)1124-1132
Number of pages9
JournalDigestive and Liver Disease
Issue number11
Publication statusPublished - Nov 1 2018


  • Bowel preparation
  • Colonoscopy
  • Guidelines
  • Inadequate bowel preparation

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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