Addition of Bisacodyl Tabs Dramatically Reduces the Frequency of Poor Colon Preps

Abstract

Purpose: Poor C-scope preps result in increased complications, costs, and missed cancers. In the past 4 years, despite 4 different 1 and 3-day prep concoctions in 3614 exams, 8% of pts had poor preps. In desperation, we sent out the dove, which returned with an olive branch and 12 tabs of bisacodyl. Our purpose is to determine whether the new C-scope prep 1) improves mucosal visualization and 2) reduces the rate of poor preps. Methods: 100 consecutive pts were prepped by the Nurse Prep clinic in the same manner as the previous 3614 pts, except for the bisacodyl. Pts were instructed to commence on the day before the exam (1) the clear liquid diet, (2) the 12 (5 mg) bisacodyl tabs (3) the gallon of Colyte, (4) the 10 oz of Mag Citrate and (5) liquids for the rest of the day. Pts read either the story of Noah or the Book of Job in the Hebrew Bible and reported to the scope room the next day either by ship or by strips of dry land. Results: There was an immediate and profound improvement in the quality of the colon preps and the behavior of the GI fellows and nursing staff. There was a 33% increase in Good or Excellent preps and a 6% decrease in Poor preps (95% CI = 23.6–42.4, P < 0.0001). Age was unrelated to the quality of the prep (P= NS) for all preps. If these results are maintained over the next 30 years, an entire year of professional services will not have been squandered.FigureFigureConclusion: Addition of 12 bisacodyl tablets (60 mg) to the already nauseating colon prep on the morning prior to the C-scope procedure results in a stunning increase in the frequency of acceptable preps.[figure1][figure2]