Skip to main content
ACG 2025 Annual Meeting Main banner
Icon Legend
This session is not in your Favorites.
This session is in your Favorites. Click again to remove it.
Presentation Icons
ACG Award Winner
ACG Award Winner
ACG Newsworthy Abstract
ACG Newsworthy Abstract
Registration Required
Registration Required
No CME
No CME
On-Demand Video
On-Demand Video
Livestream
Livestream

Monday Poster Session

Category: Colon

P2543 - Bisacodyl-Induced Ischemic Colitis Following Colonoscopy Preparation in a 58-Year-Old Female: A Case Report

Monday, October 27, 2025
10:30 AM - 4:00 PM MT
Location: Exhibit Hall
Mushfiqur Siddique, MD1, Mohannad Bitar, MD1, Hasan Al-Obaidi, MD2, Elizabeth Artiles, BS1, Satoya Beckles, BS1, Tetyana Okan, MD1, Kaushik Doshi, MD1, Avani Patel, MD1
1Jamaica Hospital Medical Center, Jamaica, NY; 2University of Toledo College of Medicine and Life Sciences, Toledo, OH

Introduction: Ischemic colitis is the most common form of intestinal ischemia. It typically affects elderly patients with cardiac comorbidities. While often multifactorial, stimulant laxative-induced ischemic colitis is a rare but increasingly recognized entity. This case report describes a 58 yr Black female who developed ischemic colitis following a routine surveillance colonoscopy using bisacodyl bowel prep.

Case Description/

Methods: A 58 yr old Black female with a history of asthma, hypercholesterolemia, and prior colon polyps presented for a routine colonoscopy.


She underwent bowel prep with a regimen including bisacodyl. Prior to the colonoscopy, she began experiencing rectal bleeding, which she attributed to the bowel prep medication. Following the colonoscopy, she developed left lower quadrant abdominal pain. She denied dizziness, leg cramps, palpitations, or chest pain. CBC was unremarkable. A follow-up colonoscopy performed on April 16, 2024, revealed endoscopic features consistent with ischemic colitis, including erythema and mucosal friability in the sigmoid colon. She was managed supportively with bowel rest, hydration, and close monitoring, leading to complete symptom resolution.



Discussion:

The association between bisacodyl and ischemic colitis has been documented in case studies. Shamatutu et al. (2020) described two patients developing IC shortly after bisacodyl-based colonoscopy preparation. Similarly, Ajani et al. (2012) reported IC in a young woman using bisacodyl and oral contraceptives. The temporal relationship between bisacodyl use and symptom onset, along with exclusion of other common causes, supports a causal link.


Our patient had several low-risk features: she was relatively young, lacked cardiovascular disease, and was not hypotensive or dehydrated. However, bisacodyl’s stimulation of colonic motility, compounded by possible dehydration from bowel prep, likely led to transient colonic hypoperfusion.

This case illustrates a rare but important adverse effect of bisacodyl, a commonly used agent for colonoscopy preparation. Clinicians should remain vigilant for signs of ischemic colitis in the immediate post-procedural period, especially in patients who develop rectal bleeding or abdominal pain. Consideration should be given to using gentler bowel regimens in at-risk populations, and patient education about potential symptoms should be part of routine counseling. Further studies are warranted to clarify the incidence and risk factors for stimulant laxative-induced ischemic colitis.

 


Figure: Friable mucosa in splenic flexure


Figure: Friable, erythematous mucosa in the descending colon

Disclosures:
Mushfiqur Siddique indicated no relevant financial relationships.
Mohannad Bitar indicated no relevant financial relationships.
Hasan Al-Obaidi indicated no relevant financial relationships.
Elizabeth Artiles indicated no relevant financial relationships.
Satoya Beckles indicated no relevant financial relationships.
Tetyana Okan indicated no relevant financial relationships.
Kaushik Doshi indicated no relevant financial relationships.
Avani Patel indicated no relevant financial relationships.

Mushfiqur Siddique, MD1, Mohannad Bitar, MD1, Hasan Al-Obaidi, MD2, Elizabeth Artiles, BS1, Satoya Beckles, BS1, Tetyana Okan, MD1, Kaushik Doshi, MD1, Avani Patel, MD1. P2543 - Bisacodyl-Induced Ischemic Colitis Following Colonoscopy Preparation in a 58-Year-Old Female: A Case Report, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.