Poor Bowel Preparation in Crohn’s Disease

Abstract

Question: An elderly man with known penetrating Crohn’s disease presents for routine colonoscopy to assess disease activity. He was in clinical remission on a combination of infliximab with mercaptopurine. A colonoscopy 6 months ago was aborted owing to poor bowel preparation in the sigmoid and transverse colon although it was noted that he had a possible narrowing in the sigmoid colon (Figure A). The patient was adamant that he took the preparation as requested. A computed tomography (CT) colonography, CT enteroclysis and repeat colonoscopy with extended bowel preparation were performed.