Article Text

Consensus guidelines for the safe prescription and administration of oral bowel-cleansing agents
  1. Andrew Connor1,
  2. Damian Tolan2,
  3. Stephen Hughes3,
  4. Nick Carr4,
  5. Charles Tomson3
  1. 1SpR, Dorset County Hospital, Dorchester, UK
  2. 2St James' University Hospital, Leeds, UK
  3. 3Southmead Hospital, Bristol, UK
  4. 4Singleton Hospital, Swansea, UK
  1. Correspondence to Dr Stephen Hughes, 43 Kellaway Avenue, Bristol BS6 7XS, UK;{at}


Oral bowel-cleansing preparations are used before colonic surgery and endoscopic and radiological assessment of the intestine to minimise faecal contamination. In February 2009, the UK National Patient Safety Agency issued a Rapid Response Report highlighting the potential risk of harm associated with the use of these preparations and instructing local NHS Trusts to implement safeguards to reduce this risk. This guidance has been prepared to help NHS Trusts to respond to these concerns, as the risk of complications is influenced by both individual patient risk factors and the choice of bowel preparation, for which definitive guidance was not previously available. This document provides an outline of the different available oral bowel-cleansing agents and the complications that may arise. This is followed by recommendations for their use in different patient groups and circumstances. The recommendations are based on consensus between the authors, each of whom circulated drafts to members of their specialist society. The evidence for these recommendations has been assessed using the modified GRADE system. The recommendations cover the choice, administration and complications (relative and absolute) of the different oral bowel-cleansing agents, with specific guidance provided for different patient groups.

  • Colonoscopy

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  • Competing interests DT has spoken at sponsored meetings since the guidelines were published in draft form, but the purpose of the meetings was to explain the guidelines to clinicians. None of the authors were involved with sponsored meetings during the preparation of these guidelines.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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