Failed prep for colonoscopy: What can I do?

My husband just went through prep while in the hospital. He was admitted after being seen in the ER for suspected blockage. Scan showed no obstruction, so admitted for observation and prep. Prep consisted of: 1st day "nothing by mouth", then 2 - 1/2 days clear liquid diet, plus 3 suppositories, 2 enema's, 2 laxatives, and 7 liters of "PEG-3350 & Electrolytes", and the Dr. still just rated the clean-out as just as "fair". How can this be???? What else could he possibly do? Dr. performed the procedure and told us it is a "slow moving gut". Anyone else have a similar experience? I am worried!

That seems excessive for bowl prep !!
What did they find after colonoscopy was done ☑️. Does he have Gastroparesis ( slow motility) that causes chronic constipation , amount other things ? If so there are medications that can help that condition .

I have extremely slow motility and a tortuous/redundant colon. I run into this issue all the time even though I always tell dr ahead of time there’s a problem. They never want to listen! Only time I ever got a totally clean prep I did it over two days. One and a half jugs of Golytely.

Hello @wifeworry and welcome to Mayo Connect. A diagnosis of "slow transit constipation" is common as we age and also if we have other health conditions and/or take medications that slow down the muscle contractions in the intestinal tract.

Many medications that are used to treat health conditions do slow the digestive tract. There are also neurological diagnoses like Parkinson's, MS that can cause the gut to slow down.

As with any problem involving constipation a change of lifestyle is needed. More exercise, more liquids, high fiber foods and the addition of products that provide bulk, like Metamucil can help. Also, the addition of stool softeners is good.

Did the doctor give your husband any information on how to treat this problem?

Thank you all for the comments. Dr. has prescribed Motegrity, but as of yet Humana has not approved filling the prescription. As background he was diagnosed (at Mayo) with PLS - similar to ALS. He has severe spasticity in his voluntary muscles (legs, hands and vocal cords) - which seems to be the opposite of what is happening in his gut. I wish there was some way to know if all of this is related or just a coincidence.

Excessive I agree! The Dr. didn't use the term gastroparesis, but I will consult with Dr. Goggle 😉 and see if that seems to apply! Starting with Motegrity - for meds - assuming Humana will OK it. Thank you!

Hello again @wifeworry,

As neurological conditions often result in constipation, have you consulted your husband's neurologist? If he takes medications for PLS, they might also be a factor.

On Mayo Clinic's website, there is information on PLS. You probably already know a great deal about this diagnosis, but you might find this information helpful. Here is the link,
--Primary lateral sclerosis (PLS)
https://www.mayoclinic.org/diseases-conditions/primary-lateral-sclerosis/symptoms-causes/syc-20353968

Whether his constipation is related to the PLS or not, it is important to treat the constipation. Is he currently taking stool softeners like Colace on a daily basis? What other constipation treatments has he tried?

Also, I'm wondering if there are problems with swallowing that might prevent drinking liquids?

I would encourage you to contact the neurologist who treats your husband for PLS about the constipation. The doctor needs to be aware of this problem and can perhaps help you get the treatment that he needs for constipation.

Will you post an update when you talk to the doctor?

Hi - I was very interested in your pill prep so googled it. It is called SuTab:
https://www.drugs.com/history/sutab.html and was approved by FDA in 2020.
I am so happy to hear because I had three episodes of projectile vomiting at the end of my last prep but was able to proceed with the procedure most likely because I go to a clear liquid diet a few days before the procedure. I kept asking for the smallest volume because gastroparesis doesn't allow ingestion a large volume of fluid without nausea and vomiting. I am definitely going to ask for SuTab at my next colonoscopy. Thank you so much for sharing!!!

Have you tried contesting the insurance company's decision? Motegrity was specifically designed to help people with severe constipation.

Hopefully it won't get to that point. Currently Humana is just asking for more info from the Dr. The Dr office is understaffed, as are most healthcare offices in our area currently. (That is why we ended up in the ER - an appointment for GI doctor was months away 🤷‍♀️). Hopefully resolved today!