[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-402945-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-402945-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","consensus-guidelines-for-the-safe-prescription-and-administration-of-oral-bowel-cleansing-agents","Consensus Guidelines for the Safe Prescription and Administration of Oral Bowel Cleansing Agents","","Consensus guidelines for safe prescription and administration of oral bowel cleansing agents before colonic surgery, endoscopic procedures, and radiological assessment of large and small intestine. The document addresses harms highlighted by a 2009 UK National Patient Safety Agency rapid response, including contraindication-related injury, phosphate nephropathy and renal failure, hypovolaemia complications, and electrolyte disturbances such as hypokalaemia, hyponatraemia, and hypermagnesaemia. It outlines the rationale for clinical assessment safeguards and explains evidence appraisal using a modified GRADE approach, including strength and quality of recommendations.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/consensus-guidelines-for-the-safe-prescription-and-administration-of-oral-bowel-cleansing-agents/402945/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/consensus-guidelines-for-the-safe-prescription-and-administration-of-oral-bowel-cleansing-agents/402945.png","ImageObject",300,407,{"name":42,"@type":43},"Stanley","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-31","2026-09-27",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why are oral bowel cleansing preparations used before procedures?","Question",{"text":63,"@type":64},"They are used before colonic surgery, endoscopic and radiological assessment of the large and small intestine to minimise faecal contamination. The document notes that, in general, they are safe and well tolerated.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What safety risks were highlighted by the 2009 NPSA rapid response report?",{"text":68,"@type":64},"The report warned of harm from prescribing to patients with definite contraindications (e.g., ileostomy or bowel obstruction), renal failure due to phosphate nephropathy, complications of hypovolaemia, and electrolyte disturbances such as hypokalaemia, hyponatraemia, and hypermagnesaemia.",{"name":70,"@type":61,"acceptedAnswer":71},"What safeguards does the NPSA guidance specifically require at local NHS Trust level?",{"text":72,"@type":64},"Each patient should receive a clinical assessment for contraindications and risks; use of the preparation must be authorised by a clinician; patients must be given an explanation on safe use; and a safe supply system must exist for each patient.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},402945,1790695549,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","CONSENSUS GUIDELINES FOR THE SAFE PRESCRIPTION AND ADMINISTRATION OF ORAL BOWEL CLEANSING AGENTS  \nProduced by:  \nDr Andrew Connor, SpR in Nephrology, Dorset County Hospital, Dorchester.  \nOn behalf of The Renal Association.  \nDr Damian Tolan, Consultant Radiologist, Leeds General Infirmary, Leeds.  \nOn behalf of the British Society of Gastrointestinal and Abdominal Radiologists for the Royal College of Radiologists  \nDr Steve Hughes, Consultant Gastroenterologist, Southmead Hospital, Bristol.  \nOn behalf of the Endoscopy Committee of The British Society of Gastroenterology.  \nMr Nick Carr, Consultant Colorectal Surgeon, Singleton Hospital, Swansea.  \nOn behalf of The Association for Coloproctology of Great Britain and Ireland for The Royal College of Surgeons.  \nDr Charles Tomson, Consultant Nephrologist, Southmead Hospital, Bristol.  \nOn behalf of The Renal Association.  \nCONTENTS  \nPage  \n3. INTRODUCTION  \n5. BACKGROUND  \n11. AN INDEX OF THE GUIDELINE STATEMENTS  \n12. GUIDELINE STATEMENTS  \n21. AREAS REQUIRING FURTHER RESEARCH  \n22. REFERENCES  \n28. APPENDIX 1: THE MODIFIED GRADE SYSTEM  \n29. APPENDIX 2: THE CLASSIFICATION OF CHRONIC KIDNEY DISEASE  \n30. APPENDIX 3: ORAL BOWEL CLEANSING AGENT PATIENT ADVICE SHEET (TEMPLATE)  \n32. APPENDIX 4: COMMENTS REGARDING POTENTIAL ADVANTAGES AND COMPLICATIONS OF INDIVIDUAL ORAL BOWEL CLEANSING AGENTS  \n33. APPENDIX 5: ORAL BOWEL CLEANSING AGENT PRESCRIPTION CHECKLIST  \nINTRODUCTION  \nOral bowel cleansing preparations are used before colonic surgery, endoscopic and radiological assessment of large and small intestine to minimise faecal contamination. In general, these preparations are safe and well tolerated. However, in February 2009, the UK National Patient Safety Agency (NPSA) issued a Rapid Response Report alerting healthcare providers to the potential risk of harm associated with the use of oral bowel cleansing preparations. 1 These risks included harm as a result of prescription of bowel preparation to patients in whom there was a definite contra-indication (e.g. presence of ileostomy; bowel obstruction); renal failure as a result of phosphate nephropathy; complications of hypovolaemia; and electrolyte disturbances including hypokalaemia, hyponatraemia, and hypermagnesaemia. Although there are no reliable estimates of the frequency of each of these complications, it is reasonable to put systems in place to reduce the risk of complications so long as this response is proportionate and does not greatly add to the complexity or cost of investigation.  \nThe NPSA Report instructed NHS Trusts that safeguards should be implemented at a local level to reduce this risk , and specifically required that all NHS Trusts ensure that a clinical assessment of each patient for contraindications and risks occurs; that the use of a bowel cleansing preparation was authorised by a clinician; that an explanation on the safe use of the preparation was provided to the patient; and that a safe system exists for the supply of the preparation for each patient. This guidance has been prepared to help in the first of these recommendations, relating to clinical assessment. We believe that guidelines are necessary because the risk of complications depends on the choice of bowel preparation and on risk factors present in the individual patient, and there has been to date no definitive guidance on which preparation to use for which patients. These guidelines are therefore aimed at a UK audience but may have relevance to other countries.  \nThe guidelines do not include recommendations on incorporation of prescription of bowel cleansing agents into the request for investigation, nor do they cover the use of oral bowel cleansing agents in children or in pregnancy. The guidelines do not cover preparation for radiological or endoscopic examination of the small bowel.  \nThese guidelines do not attempt to address the thorny issue of which bowel cleansing agent is the most effective or which regime for administration is","cbCaidAmoJevBEAC","https://ap.wps.com/l/cbCaidAmoJevBEAC","pdf",280959,34,"English","# Introduction\n## Background\n## Guideline Statements\n## Areas Requiring Further Research\n## References\n## Appendix 1: The Modified Grade System\n## Appendix 2: The Classification of Chronic Kidney Disease\n## Appendix 3: Oral Bowel Cleansing Agent Patient Advice Sheet (Template)\n## Appendix 4: Comments Regarding Potential Advantages and Complications of Individual Oral Bowel Cleansing Agents\n## Appendix 5: Oral Bowel Cleansing Agent Prescription Checklist","[{\"question\":\"Why are oral bowel cleansing preparations used before procedures?\",\"answer\":\"They are used before colonic surgery, endoscopic and radiological assessment of the large and small intestine to minimise faecal contamination. The document notes that, in general, they are safe and well tolerated.\"},{\"question\":\"What safety risks were highlighted by the 2009 NPSA rapid response report?\",\"answer\":\"The report warned of harm from prescribing to patients with definite contraindications (e.g., ileostomy or bowel obstruction), renal failure due to phosphate nephropathy, complications of hypovolaemia, and electrolyte disturbances such as hypokalaemia, hyponatraemia, and hypermagnesaemia.\"},{\"question\":\"What safeguards does the NPSA guidance specifically require at local NHS Trust level?\",\"answer\":\"Each patient should receive a clinical assessment for contraindications and risks; use of the preparation must be authorised by a clinician; patients must be given an explanation on safe use; and a safe supply system must exist for each patient.\"}]","Consensus Guidelines for the Safe Prescription and Administration of Oral Bowel Cleansing Agents | PDF",1790535544,86]