Suggested Instructions for the Chicago Bowel Preparation Scale
Chicago Bowel Preparation Scale (CBPS)
0=Unprepared colon segment with stool that cannot be cleared (>15% of the mucosa not seen)
5=Portion of mucosa in segment seen after cleaning, but up to 15% of the mucosa not seen due to
retained material
10=Minor residual material after cleaning, but mucosa of segment generally well seen
11=Entire mucosa of segment well seen after washing
12=Entire mucosa of segment well seen before washing (suctioning of liquid allowed)
CBPS
CBPS
CBPS
CBPS
Right Colon:
Transverse Colon:
Left Colon:
Fluid Whole Colon:
0 5 10 11 12
0 5 10 11 12
0 5 10 11 12
3=Lots of fluid (>300 cc)
2=Moderate fluid (151-300 cc)
1=Minimal fluid (51-150 cc) 0=Little fluid (≤50 cc)
1) Before the study begins, the raters should watch a video such as
media.bmc.org/Media/BostonBowelPreparationScale.wmv as a calibration exercise and the results should be
discussed among the raters. A lower limit on total scores should be considered to prevent one very poor colon
preparation from having an undue influence on the outcome of the study. The authors suggest a lower limit of 10.
2) Immediately after each colonoscopy, a rating form (sample shown above) should be completed. The total score is
calculated by adding the scores from all three colon segments. The fluid score is reported separately.
3) A colon segment is rated no higher than 11 if any irrigation fluid is used to clean away residual fecal material
including foamy bubbles or liquid from that segment. Ratings of 12 are allowed if the irrigation fluid is used only
to remove blood from a polypectomy site.
4) A segment is rated no higher than 10 if minor residual fecal material remains after cleaning maneuvers.
5) A segment is rated no higher than 5 if enough residual material remains so that a small polyp might be missed.
6) Any segment not seen due to technical difficulties advancing the colonoscope around the colon should not be
rated. Any colon segment that has been completely removed surgically should not be rated. A colon segment is
rated even if only a portion of it is visualized.
7) Any segment not seen because the more distal colon was too dirty to pass receives a grade of 0.
8) The anatomic borders of each colon segment are as follows: the right colon is from the proximal cecum to the midhepatic flexure; the transverse colon is from the mid-hepatic flexure to the mid-splenic flexure; and the left colon
is from the mid-splenic flexure to the distal rectum. Raters should use their best judgment to identify these
anatomic landmarks.
9) The total volume of fluid in the whole colon should be estimated by the rater and exclude any fluid injected into
the colon. Each rater should place a suction bottle (with accurate volume markings) between the vacuum source
and the colonoscope to help make these estimates until the rater feels comfortable making the estimates without
the suction bottle (the authors suggest at least 20 cases). Be sure the suction bottle is emptied of any fluid used to
test the colonoscope before it is introduced. The fluid injected into the colon is not always recovered in the suction
bottle and the net fluid suctioned from the colon often underestimates the total volume of fluid in the colon.
10) After the study is complete, the mean score for each colon segment should be calculated from all colons that had
that segment rated. The mean total score should be calculated by adding the mean scores for each of the 3 colon
segments; otherwise, unrated segments will bias the total score. The mean fluid score is reported separately and
should include all colons rated.
New Bowel Preparation Scale for Colonoscopy --- MD Questionnaire
Patient Name: __________________________________
Indication:
Patient Study ID #: _______________
Screening h/o Polyps h/o Colon Cancer FH Colon Neoplasia Rectal Bleeding
Long Standing IBD Anemia Other: ____________________________________
Findings: _________________________________________________________________
Was the Cecum Reached? Yes or No
MD: G R H
If No, Extent of Colonoscopy: ___________________
Ottawa Preparation Scale (OPS)
4=Inadequate (Solid stool not cleared with washing and suctioning)
3=Poor (Necessary to wash and suction to obtain a reasonable view)
2=Fair (Necessary to suction liquid to adequately view segment)
1=Good (Minimal turbid fluid in segment)
0=Excellent (mucosal detail clearly visible)
OPS
OPS
OPS
OPS
Right Colon:
TV/Descending Colon:
Sigmoid Colon/Rectum:
Fluid Whole Colon:
4 3 2 1
4 3 2 1
4 3 2 1
2=lots of fluid
0
0
0
1=moderate fluid
0=little fluid
Boston Bowel Preparation Scale (BBPS)
0=Unprepared colon segment with stool that cannot be cleared
1=Portion of mucosa in segment seen after cleaning, but other areas not seen due to retained material
2=Minor residual material after cleaning, but mucosa of segment generally well seen
3=Entire mucosa of segment well seen after washing
BBPS Right Colon:
BBPS TV Colon:
BBPS Left Colon:
0
0
0
1
1
1
2
2
2
3
3
3
Chicago Bowel Preparation Scale (CBPS)
0=Unprepared colon segment with stool that cannot be cleared (15+% of the mucosa not seen)
5=Portion of mucosa in segment seen after cleaning, but up to 15% of the mucosa not seen due to
retained material
10=Minor residual material after cleaning, but mucosa of segment generally well seen
11=Entire mucosa of segment well seen after washing
12=Entire mucosa of segment well seen before washing (suctioning of liquid allowed)
CBPS
CBPS
CBPS
CBPS
Right Colon:
TV Colon:
Left Colon:
Fluid Whole Colon:
0 5 10 11 12
0 5 10 11 12
0 5 10 11 12
3=Lots of fluid (300+ cc)
2=Moderate fluid (151-300 cc)
1=Minimal fluid (51-150 cc) 0=Almost no fluid (less than 50 cc)
Did you consider the preparation adequate for a good quality colonoscopy? Yes or No
New Bowel Preparation Scale for Colonoscopy --- Diane Questionnaire
Patient Name: __________________________________
Age: ____________
Sex: M or F
Patient Study ID #: _______________
Race: C AA H Other
Bowel Prep: Gatorade/PEG Other ______________
Scheduled Starting Time: ______________
Ottawa Preparation Scale (OPS)
4=Inadequate (Solid stool not cleared with washing and suctioning)
3=Poor (Necessary to wash and suction to obtain a reasonable view)
2=Fair (Necessary to suction liquid to adequately view segment)
1=Good (Minimal turbid fluid in segment)
0=Excellent (mucosal detail clearly visible)
OPS
OPS
OPS
OPS
Right Colon:
TV/Descending Colon:
Sigmoid Colon/Rectum:
Fluid Whole Colon:
4 3 2 1
4 3 2 1
4 3 2 1
2=lots of fluid
0
0
0
1=moderate fluid
0=little fluid
Boston Bowel Preparation Scale (BBPS)
0=Unprepared colon segment with stool that cannot be cleared
1=Portion of mucosa in segment seen after cleaning, but other areas not seen due to retained material
2=Minor residual material after cleaning, but mucosa of segment generally well seen
3=Entire mucosa of segment well seen after washing
BBPS Right Colon:
BBPS TV Colon:
BBPS Left Colon:
0
0
0
1
1
1
2
2
2
3
3
3
Chicago Bowel Preparation Scale (CBPS)
0=Unprepared colon segment with stool that cannot be cleared (15+% of the mucosa not seen)
5=Portion of mucosa in segment seen after cleaning, but up to 15% of the mucosa not seen due to
retained material
10=Minor residual material after cleaning, but mucosa of segment generally well seen
11=Entire mucosa of segment well seen after washing
12=Entire mucosa of segment well seen before washing (suctioning of liquid allowed)
CBPS
CBPS
CBPS
CBPS
Right Colon:
TV Colon:
Left Colon:
Fluid Whole Colon:
0 5 10 11 12
0 5 10 11 12
0 5 10 11 12
3=Lots of fluid (300+ cc)
2=Moderate fluid (151-300 cc)
1=Minimal fluid (51-150 cc) 0=Little fluid (less than 50 cc)
Did you consider the preparation adequate for a good quality colonoscopy? Yes or No
Fill out the Following Table ONLY after completing the above questionnaire.
Total Fluid Suctioned
Fluid Injected into Colon
Net Fluid Suctioned