Although it is clear that split-dose polyethylene glycol (PEG), our first-line bowel prep, provides the optimal bowel cleansing for colonoscopy, many of my patients find it difficult or even impossible to tolerate this solution (i.e., due to vomiting). Although alternatives such as Gatorade/Miralax, with or without magnesium citrate and Dulcolax, are used by many endoscopy units, these also do not work for some of my patients.
So, what approach are you taking to bowel prep for your patients with sensitive stomachs?
Specifically…
- What do you use for bowel prep in patients intolerant of standard PEG-based preps?
- What is your success rate in avoiding vomiting during this alternative prep?
- Do you ever prophylactically treat with anti-emetics before starting a prep?