Jin T, Cheng HX, Hao JY, Li C. Risk factors for inadequate bowel preparation before colonoscopy: A retrospective cohort study. World J Gastrointest Surg 2025; 17(9): 109540 [DOI: 10.4240/wjgs.v17.i9.109540]
Corresponding Author of This Article
Chao Li, Associate Chief Nurse, Department of Gastroenterology, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, No. 8 Gongren Tiyuchang South Road, Chaoyang District, Beijing 100020, China. lichaocyyy@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Sep 27, 2025; 17(9): 109540 Published online Sep 27, 2025. doi: 10.4240/wjgs.v17.i9.109540
Risk factors for inadequate bowel preparation before colonoscopy: A retrospective cohort study
Tong Jin, Hao-Xuan Cheng, Jian-Yu Hao, Chao Li
Tong Jin, Hao-Xuan Cheng, Jian-Yu Hao, Chao Li, Department of Gastroenterology, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing 100020, China
Co-first authors: Tong Jin and Hao-Xuan Cheng.
Co-corresponding authors: Jian-Yu Hao and Chao Li.
Author contributions: Jin T and Cheng HX contributed to the drafting and revision of the manuscript; Jin T and Li C were responsible for data collection and analysis; Hao JY and Li C contributed to study design, project supervision, and guidance on manuscript revision; All authors have read and approved the final manuscript.
Supported by the Beijing Key Clinical Specialty Project.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Beijing Chao-Yang Hospital, No. LGH-2024-166.
Informed consent statement: All procedures and protocols were reviewed and approved by the Institutional Review Board prior to the commencement of the study. All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: The data can be obtained from the correspondence.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao Li, Associate Chief Nurse, Department of Gastroenterology, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, No. 8 Gongren Tiyuchang South Road, Chaoyang District, Beijing 100020, China. lichaocyyy@126.com
Received: May 27, 2025 Revised: June 21, 2025 Accepted: July 24, 2025 Published online: September 27, 2025 Processing time: 122 Days and 18.4 Hours
Abstract
BACKGROUND
Bowel preparation is a critical step in colonoscopy and endoscopic surgery. Adequate and effective bowel cleansing significantly improves lesion detection rates while reducing operative risks and complications.
AIM
To investigate the current state of inadequate bowel preparation in patients undergoing colonoscopy, identify the contributing factors, and develop interventions.
METHODS
This study was designed as a retrospective cohort study. A convenience sampling method was used to select 484 patients who underwent colonoscopy at Beijing Chao-Yang Hospital, Capital Medical University, from October 2023 to October 2024. General patient data, disease-related variables, and the Boston bowel preparation scale were collected. Logistic regression analysis was conducted to identify the factors associated with inadequate bowel preparation.
RESULTS
Among the 484 patients, the rate of inadequate bowel preparation was 25.8% (125/484). Influential factors for poor bowel preparation included history of colorectal surgery [odds ratio (OR) = 5.814], low-residue diet 1 day prior (OR = 0.145), time interval from last dose to start of examination (OR = 1.447), total exercise time after medication (OR = 0.992), and total number of bowel movements after medication (OR = 0.900) (all P < 0.05).
CONCLUSION
This study highlights several modifiable and non-modifiable factors influencing bowel preparation, such as surgical history and behavioral adherence. The findings support implementing dietary adjustments, optimized laxative timing, physical activity guidance, and tailored strategies for high-risk patients to improve bowel cleansing and enhance the diagnostic accuracy of colonoscopy.
Core Tip: This retrospective study analyzed 484 patients undergoing colonoscopy and identified key factors influencing inadequate bowel preparation. History of colorectal surgery and a shorter time interval from the last dose to the start of examination were identified as risk factors, while a 1-day low-residue diet, longer total exercise time after medication, and greater defecation frequency after medication served as protective factors. These findings can help guide targeted interventions to improve bowel preparation quality and enhance diagnostic accuracy during colonoscopy.
