USMSTF Guidance on Optimizing Bowel Preparation for Colonoscopy - Episode 5
Areas for Future Bowel Preparation Research
In the fifth segment of this 6-part RX Review, experts discuss areas where more research is needed on bowel preparation for colonoscopy.
Colorectal cancer is the second leading cause of cancer-related death in the United States, a stark reality that underscores the need for effective screening and prevention.
Each March, Colorectal Cancer Awareness Month serves as a reminder of the importance of early detection to reduce colorectal cancer’s significant impact. Colonoscopy remains the gold-standard screening tool, but its effectiveness relies heavily on adequate bowel preparation. Inadequate preparation can lead to missed lesions, prolonged procedures, and the need for repeat exams, diminishing its preventive power.
New guidance from the US Multi-Society Task Force on Colorectal Cancer (USMSTF), which represents the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy, provides clinical recommendations to address challenges related to bowel preparation for colonoscopy, focusing specifically on outpatients at low risk for inadequate bowel preparation.
In the fifth segment of this 6-part HCPLive RX Review, Brian Jacobson, MD, MPH, and Joseph Anderson, MD, discuss key areas for future research and potential improvements in bowel preparation, emphasizing both clinical and technological advancements that could enhance colonoscopy outcomes.
Anderson identifies several gaps in evidence that warrant further study. One critical area is dietary recommendations leading up to colonoscopy, specifically the role of low-residue diets and fiber intake. Another area of interest he points to is optimizing one-liter bowel preparation regimens to enhance efficacy as well as research into preventative strategies for bubbles in the colon to improve visualization and efficiency.
Jacobson adds that future research could leverage artificial intelligence to personalize bowel prep regimens based on patient history, medications, and comorbidities, streamlining the scheduling process and improving adherence. Anderson agrees that predictive analytics in electronic health records could enhance patient-specific preparation plans but notes that direct patient engagement remains crucial. He says that traditional internist-led longitudinal care has diminished over the years, making it essential to reintroduce personalized interactions—whether through AI-driven insights or direct patient interviews.
Moderator: Brian Jacobson, MD, MPH, an associate professor of medicine at Harvard Medical School and director of program development for gastroenterology at Massachusetts General Hospital
Panelist: Joseph Anderson, MD, a professor of medicine at Geisel School of Medicine at Dartmouth and a gastroenterologist at White River Junction VAMC
Editors’ note: Jacobson has relevant disclosures with Curis and Guardant Health. Anderson has no relevant disclosures.
References
Jacobson BC, Anderson JC, Burke CA, et al. Optimizing Bowel Preparation Quality for Colonoscopy: Consensus Recommendations by the US Multi-Society Task Force on Colorectal Cancer. The American Journal of Gastroenterology. doi:10.14309/ajg.0000000000003287
Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. doi:10.3322/caac.21763
