BOWEL PREPARATION BEFORE COLONOSCOPY FOR CHILDREN: comparison of efficacy of three different methods

Abstract

-Background -Colonoscopy is an important diagnostic and therapeutic procedure. Adequate bowel preparation is mandatory.Several regimens were discussed in the literature. Among the drugs which has recently used, polyethylene glycol is one of the most popular agents. Objectives -The aim of this study was to compare efficacy of three different methods for 1 day preparation before colonoscopy. Methods -This study included children with the range of ages (2-21) who had an indication of colonoscopy. Exclusion criteria were based on the history of previous surgery, parental disagreement, and patients who did not use preparation protocol. Three methods for bowel preparation were studied: 1-Polyethylene glycol only; 2-Polyethylene glycol and bisacodyl suppositories; 3-Polyethylene glycol plus normal saline enema. Boston Bowel Preparation Score was used for evaluation of preparation. SPSS version 16.0 (Chicago, IL, USA) were used for data analysis. Results -In this study 83 cases completed the bowel preparation completely. Acceptable bowel preparation was seen in 24 (85.71%), 36 (94.73%), and 14 (82.35%) of cases in PEG, PEG + bisacodyl, and PEG + normal saline enema groups respectively. PEG + bisacodyl suppositories was more effective than PEG + normal saline for the preparation of the first segment (P=0.05). For second and third segment of colon, BPPS score was higher in PEG + bisacodyl suppositories compared to other regimens, but this difference was not statistically significant. Conclusion -There was no significant difference between 1 day colonoscopy regimens in terms of bowel preparation score. Lowest score was seen in PEG + enema group compared to other group. HEADINGS -Bisacodyl. Colonoscopy. Polyethylene glycols.

Bowel Preparation for Colonoscopy in Children: 1 Day PEG-3350 with Bisacodyl versus 3 Day Sennosides

“…PEG-3350 based BP protocols have been very popular in the last 2 decades in children [1]. The efficacy of PEG for BP has been a subject of investigation for a long time, and satisfactory results varied between 70 and 95% in these studies [16,17]. However, the dose and duration of PEG used, the duration of clear liquid diet, and the medications added to PEG differ as well as the scales used to evaluate the efficacy of the BPs.…”

“…The combination of PEG with a stimulant laxative is another bowel cleansing regimen that was tried [5,6,10,16,17]. Two prospective pediatric studies investigated 2-day PEG-3350 combined with bisacodyl cleanout regimen [5,6].…”

“…The authors of the latter study explained that the lower efficacy rate of their regimen might be due to the use of a meticulous definition for adequate colon preparation. There are only a few studies evaluating the efficacy of the combination of 1-day PEG with a stimulant laxative for bowel cleansing [10,16,17]. In one of these, high dose PEG (max.…”

“…In one of these, high dose PEG (max. 280 g), in combination with bisacodyl, was found to be more effective than the same dose of PEG alone regimen with a success rate of 95 vs. 86%, respectively [17]. Najafi et al [16] tested the combination of PEG (2 g/kg/ day) with bisacodyl suppository, and reported a rather low efficacy rate of 70%.…”

Single versus split dose polyethylene glycol for bowel preparation in children undergoing colonoscopy: a systematic review and meta-analysis

“…PEG is considered an effective intestinal cleansing regimen and is associated with less electrolyte imbalance (23,24). Several studies (14,(25)(26)(27) have demonstrated that PEG is superior or equal on efficacy of bowel preparation comparing with other regimens (senna, NaPico with magnesium citrate, sodium phosphate) among pediatric populations. Both senna and sodium phosphate can cause side effects, such as dehydration, which lead extra fluids intake to the patients.…”