Polyethylene glycol solutions, used for bowel preparation before colonoscopy, in theory pass through the colon without any absorption of water. However, several investigators have reported that these solutions do increase plasma volume. This review compares polyethylene and sodium phosphate bowel preparations and their effects on patients with heart failure, and also offers recommendations for patients with heart failure who need colonoscopy. ■ ■ Key Points Hyperosmotic sodium phosphate

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... ions can cause significant volume contraction in vulnerable patients, along with a risk of hyperphosphatemia. Low-volume (2-L) polyethylene glycol preparations are more tolerable than 4-L solutions. Although increases in plasma volume can be detected with polyethylene glycol solutions, these solutions are still the safest choice in patients with heart failure.