Reasons for poor colonic preparation with inpatients.

In patients often require repeated colonoscopy as a result of poor colonic preparation. A study of 101 inpatients was conducted to determine the most effective bowel preparation strategies. Results suggest patients on certain medications and with certain medical histories react differently to bowel preparation. Patients with diabetes, renal disease, chronic obstructive pulmonary disease, or chronic constipation should receive a more aggressive preparation to obtain optimal results. Likewise, patients who are taking narcotics and laxatives need to be identified and can be expected to require additional preparation to be properly cleansed. Clear liquid diet prior to the administration of the bowel preparation was the only diet modification that affected quality of preparation. The optimal bowel preparation was a 6-liter Golytely preparation along with a secondary preparation (e.g., tap water enema, Fleets enema, Dulcolax tablets). Results showed a 50% satisfactory rating of bowel preparation was achieved in patients who took 3/4 to all of their preparation. The best results were obtained when the colonoscopy procedure was conducted within 6-11 hours of bowel preparation completion.