Service de gastroentérologie, CHU de Besançon
Factors associated with the failure of the colonic cleansing is, according to the PACOME national survey, a preparation not fully taken and constipation. A consultation with gastroenterologist prior to the colonoscopy should be systematic. The main explanations must be written on an information leaflet given to patient. A decreased visualization of adenomas is described in colon with a non satisfactory preparation. Repeated colonoscopies due to poor cleansing quality generates an 50% increase of the number of screening colonoscopies. Side effects of bowel preparation are insufficiently known. The preparation should be adapted particularly in patients with renal or cardiac failures or in patients treated by inhibitors converting enzyme or angiotensin II antagonists. The last generation of preparations improves safety and acceptability by reducing volume of liquid ingested.