Abstract Background High-quality colonoscopy depends on adequate bowel cleansing, yet suboptimal preparation remains frequent. Patients with inflammatory bowel disease (IBD), who undergo colonoscopy repeatedly throughout their lives, may have greater awareness and engagement regarding preparation. This study compared bowel preparation practices and outcomes between patients with and without IBD. Methods Patients undergoing colonoscopy at a tertiary center between May and July 2025 were enrolled prospectively. Data included demographics, IBD diagnosis, type of polyethylene glycol (PEG) preparation (high-, low-, or very low-volume, chosen freely by patients), and bowel cleanliness assessed with the Boston Bowel Preparation Scale (BBPS). Differences between groups were evaluated using standard statistical tests and propensity score matching (PSM) for age and sex. Results 671 patients were enrolled, 146 with IBD and 525 controls The IBD cohort was younger (42.6 ± 15.6 vs 60.5 ± 14.0 years) with equal gender distribution, whereas the non-IBD group was 57.8% male. IBD patients preferentially selected very low-volume PEG regimens (1 L: 43%; 2 L: 36%; 4 L: 20%), while non-IBD patients chose the 4 L regimen (59%; 2 L: 23%; 1 L: 16%) mostly. Mean BBPS was significantly higher in IBD patients (7.42 ± 1.17) than in non-IBD patients (6.86 ± 1.80; p 0.001). After PSM, groups were balanced for age (≈44 vs ≈45 years), and IBD patients continued to demonstrate superior bowel cleansing (BBPS 7.40 vs 6.95; p ≈ 0.02). Conclusion Even after adjusting for age and sex via PSM, IBD patients achieved significantly better bowel cleansing and set more towards a low-volume PEG preparation. These findings suggest that improved bowel preparation in IBD patients may result not only from choosing low volumes, but also from increased awareness, engagement, and collaboration with their referring physicians. Conflict of interest: Dr. Savino, Francesco: No conflict of interest Contaldo, Antonella: No conflict of interest Principi, Maria Beatrice: No conflict of interest
Savino et al. (Thu,) studied this question.