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Key evidence and conclusions address colorectal cancer risk, the need for complete bowel cleansing for clear visualization, and comparisons of drug effectiveness and harms, including saline-based laxatives versus PEG 3350 and split-dose versus day-before regimens.",{"@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/drug-class-review-bowel-preparations/403041/",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/drug-class-review-bowel-preparations/403041.png","ImageObject",300,407,{"name":42,"@type":43},"Riley","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-27",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the purpose of the Drug Class Review: Bowel Preparations?","Question",{"text":63,"@type":64},"To review evidence for drugs used to cleanse the bowel before colonoscopy and recommend a preferred drug list class based on safety and efficacy.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why is complete bowel cleansing required before a colonoscopy?",{"text":68,"@type":64},"So the doctor can get a clear view of the intestinal tract lining and detect polyps or other precancerous lesions.",{"name":70,"@type":61,"acceptedAnswer":71},"What does the review say about split-dose dosing?",{"text":72,"@type":64},"Split dosing (half the laxative the night before and half the morning of the colonoscopy) increases detection rates of adenomas and advanced adenomas compared with day-before dosing.","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},403041,1790673513,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"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":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146,"preview_page_count":4},1374391975076,"https://ap-avatar.wpscdn.com/avatar/14000253ca4ec9f6853?x-image-process=image/resize,m_fixed,w_180,h_180&k=1783305029341752051","© Copyright 2021 Oregon State University. All Rights Reserved  \nDrug Use Research & Management Program  \nOregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079  \nPhone 503-947-5220 | Fax 503-947-2596  \nDrug Class Review: Bowel Preparations  \nDate of Review: April 2024 End Date of Literature Search: November 29, 2023  \nPurpose for Class Review:  \nReview the evidence for drugs used in cleansing the bowel prior to diagnostic or therapeutic colonoscopy. Recommend development of a Preferred Drug List (PDL) class with preferred and nonpreferred agents based on safety and efficacy.  \nPlain Language Summary:  \n􀁸 Colorectal cancer is cancer of the large intestine (colon) or rectum. The risk for having colorectal cancer is highest in people with a family history of colorectal cancer or polyps, which are small early cancer growths that form in the lining of the intestine. Other risk factors for colorectal cancer include a history of Crohn’s disease, ulcerative colitis, cigarette smoking, being overweight, or eating a lot of processed meats and high fat meals. It is recommended that people begin screening for colon cancer at 45 years of age.  \n􀁸 The easiest way to screen for colorectal cancer is by testing the stool for blood at home. This test checks for unusual bleeding in the large intestine, but it will not find polyps. A more through physical exam called a colonoscopy can find small polyps. A colonoscopy lets a doctor look inside the large intestine using an instrument called a scope. During this exam, the doctor checks for unusual inflammation, polyps, and ulcers in the large intestine. Polyps can be removed during the colonoscopy, which decreases the odds of developing cancer.  \n􀁸 Before undergoing a colonoscopy, the large intestine must be completely cleaned so the doctor can get a clear view of the intestinal tract lining. Different medicines called laxatives are used to help empty the large intestine before a colonoscopy. Most doctors prescribe polyethylene glycol (PEG) because is safe and effective. This medicine causes watery diarrhea for several hours to remove stool from the large intestine.  \n􀁸 Polyethylene glycol is supplied as 4 liters (approximately 1 gallon) of liquid which must be taken before the procedure. Many people find it difficult to drink an entire gallon of liquid the night before colonoscopy. For this reason, split-dose dosing is now recommended. In split dosing, one-half of the laxative liquid is taken the night before the procedure and the other half is taken the morning of the colonoscopy. Adding a flavor packet, drinking through a straw, and chilling the solution help improve the taste of the medicine and can reduce side effects such as nausea or bloating.  \n􀁸 An alternative to taking one gallon of PEG solution is a salt-based laxative which is available as a liquid or tablet. These products do not require the patient to drink as much fluid as the PEG products and may be easier for some people to swallow. People with heart failure, kidney problems, or liver disease should not use salt-based laxatives because the large amount of salt in these products can cause serious side effects.  \n􀁸 We recommend at least one PEG product and one oral salt-based laxative be available to Oregon Health Plan members. For all other medicines in this class, the provider must explain to the Oregon Health Authority why their patient needs that medicine. This is process is called prior authorization.  \nAuthor: Deanna Moretz, PharmD, BCPS April 2024  \nResearch Questions:  \n1. What is the comparative efficacy for saline-based laxatives and PEG 3350 for cleansing the bowel prior to colonoscopy and detecting polyps or adenomas?  \n2. What are the comparative harms of saline-based laxatives and PEG 3350 laxatives?  \n3. Are there specific populations (i.e., elderly patients, patients with renal or hepatic disease) in which certain laxative formulations are better tolerated or more effective?  \nConclusions:  \n􀁸 A li","cbCailNk2eFeKmpW","https://ap.wps.com/l/cbCailNk2eFeKmpW","pdf",1306001,26,"English","# Purpose for Class Review\n## Plain Language Summary\n## Research Questions\n## Conclusions","[{\"question\":\"What is the purpose of the Drug Class Review: Bowel Preparations?\",\"answer\":\"To review evidence for drugs used to cleanse the bowel before colonoscopy and recommend a preferred drug list class based on safety and efficacy.\"},{\"question\":\"Why is complete bowel cleansing required before a colonoscopy?\",\"answer\":\"So the doctor can get a clear view of the intestinal tract lining and detect polyps or other precancerous lesions.\"},{\"question\":\"What does the review say about split-dose dosing?\",\"answer\":\"Split dosing (half the laxative the night before and half the morning of the colonoscopy) increases detection rates of adenomas and advanced adenomas compared with day-before dosing.\"}]","Drug Class Review: Bowel Preparations | PDF",1790536828,66]