Thus, in patients with previous intolerance of large-volume preparations or in whom intolerance is anticipated because of heightened anxiety, low-volume alternatives should be considered to improve compliance, provided there are no contraindications to these agents (renal, cardiac, or liver disease). Patient education may enhance bowel preparation quality by promoting adherence to the preparation regimen. Rosenfeld and colleagues52 showed that inpatients receiving a 5-minute educational talk

regarding the reason for Talazoparib in vivo bowel preparation and the importance of preparation completion had improved preparation quality. Likewise, in a controlled trial of 436 patients, the patients randomized to receive an educational booklet had improved satisfactory bowel preparation quality (76%) compared with those not receiving a booklet (46%).53 Clear visual references show patients specific end points of colonic preparation (Fig. 4). Other studies also have confirmed the usefulness of cartoon visual aids54 and educational pamphlets55 in promoting improved bowel preparation quality. IBD surveillance mandates scrupulous bowel preparation to optimize detection of nonpolypoid dysplasia. Split-dose administration of a PEG-based regimen is recommended in patients

without contraindications. Some patients with IBD may have reduced tolerance of bowel preparation. Low-volume preparations should be considered in patients with known stenosis, dysmotility, anxiety, active disease, or previous preparation intolerance to promote adherence check details to surveillance protocols. Avoidance of unnecessary dietary restriction and provision of thorough patient education also enhance patient tolerance and compliance. “
“Cancer risk in patients with colonic inflammatory bowel disease (IBD) is high and increases over time. Quality and efficacy

of surveillance is variable in routine clinical practice. Patients with IBD involving the colon have an increased risk for CRC compared with the general population.1 Cancer in ulcerative colitis (UC) occurs at a younger age Erlotinib and increases with time, approaching 18% after 30 years of disease.1 This increased risk has prompted both the North American and United Kingdom gastroenterology societies to recommend cancer prevention strategies.2 and 3 Surveillance colonoscopies for early detection have been widely adopted to formally evaluate the benefits, risks, and costs of this approach.4, 5, 6 and 7 Despite surveillance, interval cancer rates are high in these patients. A 2006 Cochrane review found no clear evidence that surveillance colonoscopy prolongs survival in patients with extensive colitis.8 In the same year, a 30-year analysis of surveillance practice from St Mark’s hospital reported that more than 50% of detected cancers were found to be interval cancers.