Comparison of one and two-day bowel preparation with polyethylene glycol in pediatric colonoscopy

Abstract

Background/Aims: Proper colon preparation in children has been a challenge for many years. Different regimens have been used for this purpose, but the best regimen is not determined. The aim of this study was to evaluate successful colon preparation before colonoscopy in children who were treated with one-or two-day regimen with polyethylene glycol (PEG) plus bisacodyl and clear liquids. Materials and Methods: In this randomized clinical trial, 100 children (2-14 years old) who were candidates for colonoscopy were enrolled and divided into two groups. The children in group one were started on 2 g/kg PEG powder (17 g in 240 mL water or another beverage) and 5 mg bisacodyl suppository (BD) the day before colonoscopy, whereas those in the other group were started on 1.5 g/kg PEG with fruit juices for two days and 5 mg bisacodyl suppository (BD) for two days before colonoscopy. Results: Compliance rates, regimens, adverse effects, and complete colonoscopy were not significantly different between the two groups. The Boston score was excellent and good in 70% of group one and 72% of group two children, respectively. Compliance rate, adverse effects, and need for enema were similar in both groups. The rate of compliance and non-requirement of enema were significantly higher in children with satisfactory colon preparation. Conclusion: The one-day PEG plus bisacodyl regimen for bowel preparation is as effective as the two-day regimen in children; furthermore, it is well tolerated and has low adverse effects.

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

“…These results are comparable to the rates reported with 1-day high-dose PEG-3350 regimens [7,8] but much higher than the rate reported in the study conducted with a similar low dose of PEG-B [16].…”

“…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.…”

“…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%. Boston scale was used to assess the efficacy of the bowel cleansing methods in both studies.…”