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This intensified bowel preparation regimen is a personalized protocol developed and evaluated by Rambam Health Care Campus for patients with risk factors for inadequate bowel preparation (IBP) undergoing colonoscopy. The regimen combines three distinct laxative products to ensure optimal cleansing: a triple-combination stimulant and osmotic laxative (sodium picosulfate, magnesium oxide, and citric acid), an additional osmotic laxative (polyethylene glycol), and a stimulant laxative (bisacodyl). Sodium picosulfate and bisacodyl act by stimulating the colonic mucosa to increase peristalsis. Magnesium oxide and citric acid react in water to form magnesium citrate, which, along with polyethylene glycol, creates an osmotic effect that draws water into the intestinal lumen, softening the stool and increasing its volume to facilitate thorough evacuation.
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