PUBLIC LIBRARY / CALCULATOR

Boston Bowel Preparation Scale (BBPS)

Scores each colon segment’s cleanliness after washing and suction. Standardizes reporting and determines whether preparation was adequate to detect polyps.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

BBPS/Lai 2009: 3 segments 0–3 after washing/suction; total 0–9

BBPS was developed to score cleanliness observed during inspection after washing and suction by the endoscopist. The original single-center study does not automatically confirm adequacy cutoffs or repeat intervals adopted in later recommendations. Assessment of each segment and the edition of those criteria must be preserved.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Right colon (cecum and ascending colon)
Transverse colon (including flexures)
Left colon (descending, sigmoid and rectum)

4/4 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Each segment scores 0 to 3 after washing and suction:

0: unprepared segment; mucosa obscured by solid stool that cannot be cleared.
1: some mucosa visible; other areas obscured by staining, residual stool or opaque liquid.
2: minor residue; mucosa well seen.
3: all mucosa well seen, no residue.

Total 0 to 9.

References

Identifier: boston-bowel-preparation-scale

Original clinical content: Brazilian Portuguese.

Method version

BBPS/Lai 2009: 3 segments 0–3 after washing/suction; total 0–9

boston-bowel-preparation-scale@native-2026-10-05+62836663b092

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (4)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Right colon (cecum and ascending colon): 3 – Entire mucosa clearly seen
Transverse colon (including flexures): 3 – Entire mucosa clearly seen
Left colon (descending, sigmoid and rectum): 3 – Entire mucosa clearly seen

{
  "dir": "3",
  "trans": "3",
  "esq": "3"
}

Expected result

{
  "score": 9,
  "level": "low",
  "verdict": "adequado"
}

Actual result

{
  "score": 9,
  "adequate": 1
}

Case 2

reference-002

Inputs

Right colon (cecum and ascending colon): 2 – Minimal residue, mucosa clearly seen
Transverse colon (including flexures): 2 – Minimal residue, mucosa clearly seen
Left colon (descending, sigmoid and rectum): 2 – Minimal residue, mucosa clearly seen

{
  "dir": "2",
  "trans": "2",
  "esq": "2"
}

Expected result

{
  "score": 6,
  "level": "low",
  "verdict": "adequado"
}

Actual result

{
  "score": 6,
  "adequate": 1
}

Case 3

reference-003

Inputs

Right colon (cecum and ascending colon): 1 – Part of mucosa seen
Transverse colon (including flexures): 3 – Entire mucosa clearly seen
Left colon (descending, sigmoid and rectum): 3 – Entire mucosa clearly seen

{
  "dir": "1",
  "trans": "3",
  "esq": "3"
}

Expected result

{
  "score": 7,
  "level": "high",
  "verdict": "inadequado"
}

Actual result

{
  "score": 7,
  "adequate": 0
}

Case 4

reference-004

Inputs

Right colon (cecum and ascending colon): 1 – Part of mucosa seen
Transverse colon (including flexures): 1 – Part of mucosa seen
Left colon (descending, sigmoid and rectum): 1 – Part of mucosa seen

{
  "dir": "1",
  "trans": "1",
  "esq": "1"
}

Expected result

{
  "score": 3,
  "level": "high"
}

Actual result

{
  "score": 3,
  "adequate": 0
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

README

Local installation

Code license: Apache-2.0

Guidelines and conditions

This repository’s license applies to the code. Third-party instruments, questionnaires, data and models remain subject to their owners’ conditions.

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.