S3167 Utilization of a Low-Volume Bowel Preparation in the Inpatient Setting: A Retrospective Study

Abstract

INTRODUCTION: Large volume preparations that are polyethylene glycol based (GoLYTELY and MiraLAX) are the mainstay of bowel preparation regiment at many institutions. Studies have shown that patients prefer lower volume preparations compared to the standard 4 Liter GoLYTELY. Although data has been collected on low volume bowel preparation efficacy in the outpatient setting for elective colonoscopy, there is little data on low volume bowel preparations in the inpatient setting. We performed a retrospective review of patients who received Clenpiq, a low volume bowel preparation for colonoscopies at our institution. METHODS: A retrospective review from the past year was done to assess which patients underwent bowel preparation with Clenpiq (sodium picosulfate, magnesium oxide, and anhydrous citric acid) at a single institution. On the evening prior to the colonoscopy, patients were instructed to drink 2 bottles of Clenpiq (160 mL solution) six hours apart. Each bottle was followed by 32 oz ounces of clear liquids. Contraindications included severe renal impairment (CrCl < 30 mL/min), GI obstruction and ileus, bowel perforation, colitis, gastric retention, hypersensitivity to compounds of formula. RESULTS: 10 patients were analyzed (mean age 57.5, eight female, two male). 7 patients completed the preparation, while 2 patients could not complete it due to nausea / vomiting. There were 0 cases that needed to be rescheduled due to inadequate bowel preparation. 6 out of 8 cases were reported to be good or excellent bowel preparation per the endoscopist report. CONCLUSION: The inpatient hospital setting compared with the ambulatory setting, has been associated with almost a two-fold higher risk of inadequate bowel preparation prior to colonoscopy. Inadequate bowel preparation is associated with increased risk of missed lesions, resulting in repeat and lengthier procedures. From our limited data, the majority of patients that took Clenpiq prior to colonoscopy, were able to fully finish the prep, had adequate prep and were able to tolerate it without any adverse reactions. As a result of the COVID-19 pandemic, and major limitations on elective cases, we will pursue prospective analysis of cases in the future. Further research should be done to compare ClenPiq with GoLytely as an alternative to routine bowel prep in hospitalized patients.Figure 1.: Seven out of the ten patients completed the preparation. Two patients had an adverse reaction to the preparation.Figure 2.: Eight out of the ten patients underwent their scheduled procedure.Figure 3.: Quality of bowel preparation as reported by the endoscopist. Five out of the eight procedures were reported as good, one out of eight was reported as excellent.