Risk factors for inadequate bowel preparation before colonoscopy in inpatients with inflammatory bowel disease: a cross-sectional study

Colonoscopy is a crucial diagnostic tool for patients with inflammatory bowel disease (IBD) and adequate bowel preparation is of critical importance in this population. However, current data on the factors influencing bowel preparation in IBD patients remain limited. This study aims to identify factors affecting bowel preparation in IBD patients, enabling healthcare professionals to recognize high-risk patients with inadequate bowel preparation in clinical practice and to develop individualized bowel preparation regimens. This cross-sectional study included IBD inpatients who underwent colonoscopy at the Endoscopy Center of a tertiary general hospital in Suzhou between January 1, 2025, and December 31, 2025. Patients were classified with adequate bowel preparation and inadequate bowel preparation based on the Boston Bowel Preparation Scale (BBPS). Univariate analysis was performed using SPSS 21.0 software. Significant factors were included in a binary logistic regression model for multivariate analysis to identify independent risk factors for inadequate bowel preparation in IBD patients. A total of 241 IBD patients were enrolled, and 225 valid questionnaires were finally included for analysis, with an inadequate bowel preparation rate of 21.78%. Univariate analysis showed significant differences between the adequate and inadequate preparation groups in terms of gender, height, history of inadequate bowel preparation, current dietary status, perianal lesions, intestinal strictures, and the time interval between laxative completion and colonoscopy initiation. Multivariate analysis revealed that height, history of inadequate bowel preparation, perianal lesions, intestinal strictures and the interval from the completion of laxative intake to the start of colonoscopy > 6 h were independent factors associated with inadequate bowel preparation in IBD patients. The rate of inadequate bowel preparation is high among IBD patients. Height, history of inadequate bowel preparation, perianal lesions, intestinal strictures, and the interval from the completion of laxative intake to the start of colonoscopy> 6 h were independently associated with inadequate bowel preparation in IBD patients. These factors may help identify high-risk IBD patients for individualized preparation strategies, thereby improving the quality of bowel preparation.