Publications

Surveillance colonoscopy in patients with inflammatory bowel disease (IBD) with colonic involvement is recommended by multiple national and international gastrointestinal societies. Recommendations differ on the timing of initial screening colonoscopy, recommended surveillance intervals, optimal technique for dysplasia detection, and management of endoscopically visible and nonvisible dysplasia. This article reviews current society guidelines, highlighting similarities and differences, in an attempt to summarize areas of consensus on surveillance protocols in IBD, while drawing attention to controversial areas in need of further research.

Colonoscopy is routinely performed in patients with inflammatory bowel disease (IBD) for surveillance of dysplasia. Thorough bowel preparation is necessary to facilitate lesion detection. Patients with IBD do not have poorer bowel preparation outcomes but may have decreased preparation tolerance affecting adherence to surveillance protocols. A low-fiber prepreparation diet may improve preparation tolerance without affecting preparation quality. The standard preparation regimen should consist of split-dose administration of a polyethylene glycol-based purgative. Low-volume, hyperosmolar purgatives may be considered in patients with previous preparation intolerance, heightened anxiety, stenotic disease, or dysmotility. Appropriate patient education is critical to enhance preparation quality.