Repeated colonoscopy results after an unsuccessful procedure due to inadequate bowel cleansing

INTRODUCTION: The aim of this study is to evaluate repeated colonoscopy results after a failed procedure due to inadequate bowel cleansing.
METHODS: Patients who underwent colonoscopy between the dates of January 2014 and December 2019 were included in the study. Patients’ distance from the hospital, appointment times, repeated colonoscopy times, demographic data, and predictive factors were evaluated.
RESULTS: There were 522 (5.1%) patients who had failed procedure due to insufficient bowel cleansing among the 10,420 colonoscopy procedures. Failure rates were increased in each repeated colonoscopies (21.8%, 25%, and 33.3%). In repeated second colonoscopy, if the procedure was on the same day and the next day, it was associated with a high success rate (odds ratio [OR]=3.31, 95% confidence interval [CI]=0.91–12.36; p=0.048, OR=3.22, 95% CI=1.26–8.24; p=0.011, respectively). Elder age (OR=1.04, 95% CI=1.02–1.06; p<0.001), diabetes mellitus (OR=5.23, 95% CI=2.92–9.38; p<0.001), neurologic disorders (OR=7.02, 95% CI=3.12–15.8; p<0.001), and constipation (p<0.001) were defined as risk factors for inadequate bowel cleansing. Patients who did not attend the second recurrent colonoscopy appointment had a significantly higher distance from the hospital compared to the patients who attended the appointment (p<0.001).
DISCUSSION AND CONCLUSION: The failure rates in repeated colonoscopies after inadequate bowel preparation continues exponentially. In this difficult patient group, failure rates can be reduced by repeating colonoscopy on the same day or the next day. It is extremely important to know the risk factors before the procedure and to determine patient management accordingly.