Emerging space for non-polyethene-glycol bowel preparations in inflammatory bowel disease-related colonoscopy: Veering toward better adherence and palatability

Interventions to improve bowel cleansing in colonoscopy

INTRODUCTION

Suboptimal bowel preparation adversely affects colonoscopy quality, increases healthcare costs, and prolongs waiting time. The primary contributing factors include poor tolerance to the preparation solutions, noncompliance with prescribed instructions, and suboptimal efficacy of the bowel cleansing solution itself.

AREAS COVERED

This review examined the predictive factors associated with suboptimal bowel preparation and discussed interventions aimed at improving bowel cleansing. It also provides evidence-based practical algorithms supplemented by insights from our own clinical experience. Relevant topics were reviewed using resources from the PubMed database.

EXPERT OPINION

Although current bowel preparation protocols are effective for the majority of patients, a significant proportion still present challenges for optimal preparation. These patients may benefit from personalized strategies tailored to the specific causes of preparation failure. Conducting a thorough interview is crucial for identifying the reasons for failure, particularly in patients who have previously experienced suboptimal preparation during colonoscopy. In colonoscopy-naïve patients, it is essential to assess the risk of suboptimal preparation. In both cases, interventions should be customized to either address the identified causes in the former group or employ preventive strategies to reduce the likelihood of failure in the latter.

Water-assisted colonoscopy in inflammatory bowel diseases: From technical implications to diagnostic and therapeutic potentials

Water-assisted colonoscopy (WAC) application in inflammatory bowel diseases (IBD) endoscopy offers significant technical opportunities. Traditional gas-aided insufflation colonoscopy increases patient discomfort, presenting challenges in the frequent and detailed mucosal assessments required for IBD endoscopy. WAC techniques, including water immersion and exchange, provide superior patient comfort and enhanced endoscopic visualisation. WAC effectively reduces procedural pain, enhances bowel cleanliness, and increases adenoma detection rates, which is crucial for colorectal cancer screening and disease-related evaluations in IBD patients. Additionally, underwater techniques facilitate basic and advanced endoscopic resections, such as polypectomy and endoscopic mucosal and submucosal resections, often required for resecting IBD-associated neoplasia.

Navigating new horizons in inflammatory bowel disease: Integrative approaches and innovations

This editorial offers an updated synthesis of the major advancements in the management and treatment of inflammatory bowel disease (IBD), as documented in the World Journal of Gastroenterology between 2023 and early 2024. This editorial explores substantial developments across key research areas, such as intestinal microecology, computational drug discovery, dual biologic therapy, telemedicine, and the integration of lifestyle changes into patient care. Furthermore, the discussion of emerging topics, including bowel preparation in colonoscopy, the impact of the coronavirus disease 2019 pandemic, and the intersection between IBD and mental health, reflects a shift toward a more holistic approach to IBD research. By integrating these diverse areas of research, this editorial seeks to promote a holistic and multidisciplinary approach to IBD treatment, combining emerging technologies, personalized medicine, and conventional therapies to improve patient outcomes.

Editor-in-Chief articles of choice and comments at the year-end of 2023

As the Editor-in-Chief of World Journal of Gastroenterology, every week prior to a new issue's online publication, I perform a careful review of all encompassed articles, including the title, clinical and/or research importance, originality, novelty, and ratings by the peer reviewers. Based on this review, I select the papers of choice and suggest pertinent changes (e.g., in the title) to the Company Editors responsible for publication. This process, while time-consuming, is very important for assuring the quality of publications and highlighting important articles that Readers may revisit.