Ischemic Colitis after Colonoscopy with Bisacodyl Bowel Preparation: A Report of Two Cases

Table 1

Literature review results of ischemic colitis induced by bowel cathartics. Search run, August 2019.

First author, year	Age	Sex	Risk factors	Laxative; Type; Dose; Reason	Onset to symptoms (hours)	Symptoms	Diagnosis	Complications	Treatment	Resolution
Oh [15], 1997	69	F	Age, HTN, and DM	Magnesium citrate; NA; Bowel preparation	1 hour after magnesium citrate	Abdopain and hematochezia	Colonoscopy	None	Conservative	D/C 7 days
Oh [15], 1997	66	F	Age and CAD	Sodium phosphate; NA; Bowel preparation	0.5 hours after sodium phosphate	Abdopain, nausea, emesis, and diarrhea	Colonoscopy	None	Conservative	D/C 2 days
Lopez [18], 2005	19	M	Constipation	Bisacodyl; 5 mg; Constipation	Several hours after bisacodyl	Abdopain, hematochezia, and fever	Colonoscopy and CT	None	Conservative	D/C 2 days
Lopez [18], 2005	33	F	Constipation; Sertraline	Bisacodyl; 10 mg; Constipation	6 hours after bisacodyl	Abdopain and hematochezia	Colonoscopy	None	Conservative	D/C 2 days
Vaizman [19], 2007	56	M	HTN	Bisacodyl/PEG 3350; 20 mg/NA; Bowel preparation	After bisacodyl/PEG (unspecified)	Abdopain, hematochezia, and diarrhea	Colonoscopy	NA	NA	NA
Lee [20], 2008 (no English text)	39	F	None	Magnesium citrate; 250 ml; Bowel preparation	24 hours after magnesium citrate	Abdopain and hematochezia	Colonoscopy	None	Conservative	D/C 3 days
You [21], 2009 (no English text)	70	F	Age, COPD, and chronic constipation	SF-PEG; 4 L; Bowel preparation	0.5 hours after SF-PEG	Abdopain	Colonoscopy	NA	NA	NA
Baudet [16], 2010	68, 70	M	Age	Bisacodyl/PEG; 10 mg/2 L; Bowel preparation	2 hours after bisacodyl	Abdopain and hematochezia	Colonoscopy	None	NA	NA
Dholakia [22], 2011 (abstract only)	37	F	None	Bisacodyl/PEG 3350; NA; Bowel preparation	24 hours after bisacodyl/PEG 3350	NA	Colonoscopy	None	NA	NA
Ajani [17], 2012	54	F	Chronic constipation; OCP (estradiol 0.5 mg daily)	Bisacodyl; 15 mg; Bowel preparation for non-GI surgery	6 hours after bisacodyl	Abdopain, hematochezia, and diarrhea	Colonoscopy and CT	None	Conservative	NA
Sherid [23], 2013	54	F	DM, HTN, dyslipidemia, and chronic constipation	Lubiprostone; 24 mcg; Constipation	2 hours after lubiprostone	Abdopain, nausea, clear emesis, and hematochezia	Colonoscopy	None	Stopping lubiprostone	D/C 4 days
Behzadi [24], 2015 (abstract only)	64	F	None	Bisacodyl/PEG 3350; 15 mg/2 L; Bowel preparation	Several hours after bisacodyl/PEG 3350	Abdopain, nausea, clear emesis, and diarrhea	Colonoscopy and biopsy	None	Conservative	D/C several days

Recurrence in same individual 2 years later with same bowel preparation and same clinical course. Abdopain, abdominal pain; HTN, hypertension; DM, diabetes mellitus; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; OCP, oral contraceptive pill; NA, not available; D/C, day of discharge; CT, computerized tomography. Conservative treatment in all cases consisted of IV fluids ± antibiotics.