title: Rescue bowel preparation: same day 2 L polyethylene glycol addition, not superior to bisacodyl addition 7 days later.
abstract: BACKGROUND
  The optimal colon-cleansing method after failure of bowel preparation (BP) for colonoscopy has not been established.
  
  
  OBJECTIVE
  We aimed to compare BP rescue methods after failed initial BP and to identify risk factors for rescue BP failure.
  
  
  METHODS
  Eighty-five patients with BP failure after 4 L polyethylene glycol (PEG) ingestion were prospectively enrolled from March 2008 to March 2012. A second colonoscopy was performed either on the same day after ingestion of another 2 L PEG (group A) or 1 week later after ingestion of 4 L PEG plus 20 mg oral bisacodyl (group B). Differences between groups in terms of BP quality and risk factors for a poor BP on the second colonoscopy were investigated.
  
  
  RESULTS
  Median patient age was 59 years, 45 were male (52.9 %), and 17 (20 %) had poor BP on the second colonoscopy. For group B, the multivariable-adjusted odds ratio (OR) for poor BP on the second colonoscopy relative to group A was 0.68 (95 % confidence interval [CI], 0.16-2.95). Adequately ingested PEG during the initial colonoscopy was associated with poor BP on the second colonoscopy (OR 4.05; 95 % CI 1.04-15.75). The two groups had similar patient discomfort rates during the second BP.
  
  
  CONCLUSIONS
  The two groups did not differ in rescue BP failure rate. Initial BP failure after adequate consumption of 4 L PEG may be a risk factor for rescue BP failure. A stricter BP regimen should be considered for these patients.
authors.affiliation: Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Jeung Hye
authors.initials: JH
authors.lastname: Han
authors.forename: Sun-Jin
authors.initials: SJ
authors.lastname: Boo
authors.forename: Ock Bae
authors.initials: OB
authors.lastname: Ko
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Park
authors.forename: Sang Hyoung
authors.initials: SH
authors.lastname: Park
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Yang
authors.forename: Kee Wook
authors.initials: KW
authors.lastname: Jung
authors.forename: Kyung-Jo
authors.initials: KJ
authors.lastname: Kim
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
mesh_terms: D000368:Aged; D001726:Bisacodyl / Q000008:administration & dosage* / Q000009:adverse effects; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy / Q000379:methods* / Q000592:standards; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D017211:Treatment Failure
chemical_list: D002400:Cathartics; D001726:Bisacodyl; D011092:Polyethylene Glycols
references.citation: Am J Gastroenterol. 2006 Dec;101(12):2719-25
references.pmid: 17026559
references.citation: Gastrointest Endosc. 2005 Jan;61(1):72-5
references.pmid: 15672059
references.citation: Gastrointest Endosc. 2005 Aug;62(2):213-8
references.pmid: 16046981
references.citation: World J Gastroenterol. 2006 Oct 14;12(38):6161-6
references.pmid: 17036388
references.citation: Gastrointest Endosc. 2006 Jun;63(7):894-909
references.pmid: 16733101
references.citation: J Gastrointestin Liver Dis. 2010 Dec;19(4):369-72
references.pmid: 21188326
references.citation: Dig Dis Sci. 2009 Apr;54(4):833-41
references.pmid: 18712479
references.citation: Dig Dis Sci. 2011 Feb;56(2):539-44
references.pmid: 21042853
references.citation: J Clin Gastroenterol. 2009 May-Jun;43(5):448-52
references.pmid: 18978506
references.citation: Endoscopy. 2013;45(2):142-50
references.pmid: 23335011
references.citation: Gastrointest Endosc. 2009 Mar;69(3 Pt 2):626-30
references.pmid: 19251002
references.citation: Gastrointest Endosc. 2010 Aug;72(2):313-20
references.pmid: 20561621
references.citation: Gastrointest Endosc. 2009 Mar;69(3 Pt 2):700-6
references.pmid: 19251013
references.citation: Gastrointest Endosc. 2005 Mar;61(3):378-84
references.pmid: 15758907
references.citation: Aliment Pharmacol Ther. 2007 Feb 15;25(4):373-84
references.pmid: 17269992
references.citation: Aliment Pharmacol Ther. 2006 Dec;24(11-12):1631-42
references.pmid: 17094774
references.citation: Am J Gastroenterol. 2001 Jun;96(6):1797-802
references.pmid: 11419832