LARGE INTESTINE: Edited by Eamonn M.M. QuigleyBowel preparation for colonoscopy what is best and necessary for quality?Parekh, Parth J.a; Oldfield, Edward C. IVb; Johnson, David A.bAuthor Information aDivision of Gastroenterology and Hepatology bDepartment of Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA Correspondence to David A. Johnson, MD, MACG, FASGE, MACP, Professor of Medicine, Chief, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA 23510, USA. E-mail: email@example.com. Current Opinion in Gastroenterology: January 2019 - Volume 35 - Issue 1 - p 51-57 doi: 10.1097/MOG.0000000000000494 Buy Metrics Abstract Purpose of review Colonoscopy is recognizably, the best colon cancer prevention test, provided the quality of the preparation is adequate for detection of precancerous polyps but also allowing for accurate identification of margins, thereby facilitating complete endoscopic resection. As there are many aspects effecting colon prep outcomes, it is timely to review new standards for optimizing outcomes, including product selection based on patient demographics. Recent findings New national guidelines have set a minimum quality threshold for adequacy and also defined a split day delivery for oral options as the “standard of care”. Several new prep options have been recently released and these data are discussed. Summary Optimizing the quality of colon preps has major implications for clinical practice. Clinicians must recognize new targets for standard of care, providing the best approach for each individual patient, considering variable factors which may otherwise compromise success. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.