Management of the Poorly Prepared Colonoscopy Patient: Colonoscopic Colon Enemas as a Preparation for Colonoscopy

Purpose Colonoscopic colon enema is an option for the management of patients who are suboptimally prepared for colonoscopic examination because of retained fecal material. Methods After colonoscopy is performed and the colonoscopist has reached the right colon and the colon is deemed to be inadequately prepared, the contents of two commercially available bisacodyl enemas are combined and instilled into the right colon via the colonoscope biopsy channel. Patients are allowed to recover from propofol sedation, expel the lumenal contents, resedated, and examined. Results In this fashion, 21 patients during a 19-month period were successfully cleansed of their retained fecal contents, permitting satisfactory colonoscopic examinations. This avoided the need for postponement of the procedure. Conclusions Colonoscopic colon enema is an innovative and simple option available to the colonoscopist to manage the patient with an inadequately prepared colon. Presented at the meeting of the American College of Gastroenterology, Philadelphia, Pennsylvania, October 12 to 17, 2007.