High‐ Versus Low‐Volume Polyethylene Glycol Plus Laxative Versus Sennosides for Colonoscopy Preparation in Children

Kierkuś, Jarosław; Horvath, Andrea; Szychta, Monika; Woynarowski, Marek; Wegner, Agnieszka; Wiernicka, Anna; Dądalski, Maciej; Teisseyre, Mikołaj; Dziechciarz, Piotr

doi:10.1097/mpg.0b013e3182950ef5

Cited by 20 publications

(23 citation statements)

References 27 publications

(48 reference statements)

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“…Some studies specify the cleaning result with scoring systems similar to the Aronchick score, reporting good to excellent cleaning results with rates ranging from 40 % to 100 %. 4 5 7 8 11 12 16 17 18 19. In published studies the preparation time seems to have an important influence on the cleaning result.…”

Section: Resultsmentioning

confidence: 99%

“…In 1 study nasogastric tubes were necessary in the majority of children 6. Thus the majority of studies in recent years have used electrolyte-free PEG preparations 3 8 10 11 12 17 23.…”

Section: Resultsmentioning

confidence: 99%

“…In 2010 Hunter and Mamula reviewed the literature, comprising 8 randomized clinical trials, and stated: “Based on the available data it is difficult to make precise comparisons…” and “…the existing agents require further evaluation regarding their safety and dose profiles that provides appropriate preparations with minimal adverse events.” 9. The results of the studies published after conclusion of this review do not change this overall image 3 7 8 10 11 12. The authors of the only existing evidence-based recommendations conclude: “There is no ideal bowel cleansing regimen and, thus, numerous cleanout protocols are in use.” 13.…”

Section: Introductionmentioning

confidence: 89%

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Bowel preparation in pediatric colonoscopy: results of an open observational study

Berger¹,

Claßen

Engelhardt³

et al. 2016

Endosc Int Open

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Background and study aims: The goal of this study was to analyze the bowel cleansing methods currently used for pediatric colonoscopy in terms of effectiveness, tolerance and safety. Patients and methods: Data from 768 colonoscopies reported by 28 centers were registered in an online database for further analysis. Binary logistic regression was used to determine how preparation methods affected the cleaning effect (Aronchick score) and the rate of adverse events (Aes) and complications. Results: The most frequently reported cleansing agents were sodium picosulphate (54.2?%) and polyethylene-glycol (41.3?%) in various combinations. The cleaning effect was good to excellent in 72.6?% of patients. AEs during the preparation period occurred in 21.5?% of patients. Complications during endoscopy were reported in 12.1?% and were mostly mild. The different agents had no influence on the cleaning effect. In contrast the risk of AEs during preparation was significantly increased when polyethylene-glycol was used (odds ratio (OR) 2.112, P?=?0.002) but reduced with the use of sodium picosulphate (OR 0.380, P?

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Section: Resultsmentioning

confidence: 99%

“…In 1 study nasogastric tubes were necessary in the majority of children 6. Thus the majority of studies in recent years have used electrolyte-free PEG preparations 3 8 10 11 12 17 23.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

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Bowel preparation in pediatric colonoscopy: results of an open observational study

Berger¹,

Claßen

Engelhardt³

et al. 2016

Endosc Int Open

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“…Interestingly, we noticed a decrease in the number of discharges for abdominal pain by 22.0% starting in 2003. This phenomenon may correlate with an increase in the outpatient performance of diagnostic procedures including outpatient bowel 'cleanouts' 19 and early detection of celiac disease. 20 The frequency of constipation discharges also increased significantly by 112% from 5.9/10 000 discharges in 1997 to 12.5/ 10 000 discharges in 2009.…”

Section: Discussionmentioning

confidence: 99%

Inpatient burden of childhood functional GI disorders in the USA: an analysis of national trends in the USA from 1997 to 2009

Park

Mikami

LeClair

et al. 2015

Neurogastroenterology Motil

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BACKGROUND Functional Gastrointestinal Disorders (FGIDs) are among the most common outpatient diagnoses in pediatric primary care and gastroenterology. There is limited data on the inpatient burden of childhood FGIDs in the U.S. The aim of this study was to evaluate the inpatient admission rate, length of stay, and associated costs related to FGIDs from 1997–2009. METHODS We analyzed the Kids’ Inpatient Sample Database (KID) for all subjects in which constipation (ICD-9 codes: 564.0–564.09), abdominal pain (ICD-9 codes: 789.0–789.09), irritable bowel syndrome (IBS) (ICD-9 code: 564.1), abdominal migraine (ICD-9 code:346.80 and 346.81)dyspepsia (ICD-9 code: 536.8) or fecal incontinence (ICD-codes: 787.6–787.63) was the primary discharge diagnosis from 1997–2009. The KID is the largest publicly available all-payer inpatient database in the U.S., containing data from 2–3 million pediatric hospital stays yearly. KEY RESULTS From 1997–2009, the number of discharges with a FGID primary diagnosis increased slightly from 6,348,537 to 6,393,803. The total mean cost per discharge increased significantly from $6115 to $18,058 despite the length of stay remaining relatively stable. Constipation and abdominal pain were the most common FGID discharge diagnoses. Abdominal pain and abdominal migraine discharges were most frequent in the 10–14 year age group. Constipation and fecal incontinence discharges were most frequent in the 5–9 year age group. IBS discharge was most common for the 15–17 year age group. CONCLUSIONS AND INFERENCES Hospitalizations and associated costs in childhood FGIDs have increased in number and cost in the U.S. from 1997–2009. Further studies to determine optimal methods to avoid unnecessary hospitalizations and potentially harmful diagnostic testing are indicated.

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“…A recent study by Kierkus et al [155] included 10-18-yearold patients randomly assigned to receive either PEG 60 or PEG 30 mL/kg per day plus oral bisacodyl 10-15 mg/ . These results showed that high-volume PEG, low-volume PEG plus a laxative stimulant, and sennosides have similar effectiveness and are equally tolerated by patients being prepared for colonoscopy.…”

Section: Pediatric Patientsmentioning

confidence: 99%

Achieving the best bowel preparation for colonoscopy

Parra‐Blanco¹,

Ruiz²,

Álvarez-Lobos³

et al. 2014

WJG

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Bowel preparation is a core issue in colonoscopy, as it is closely related to the quality of the procedure. Patients often find that bowel preparation is the most unpleasant part of the examination. It is widely accepted that the quality of cleansing must be excellent to facilitate detecting neoplastic lesions. In spite of its importance and potential implications, until recently, bowel preparation has not been the subject of much study. The most commonly used agents are high-volume polyethylene glycol (PEG) electrolyte solution and sodium phosphate. There has been some confusion, even in published meta-analyses, regarding which of the two agents provides better cleansing. It is clear now that both PEG and sodium phosphate are effective when administered with proper timing. Consequently, the timing of administration is recognized as one of the central factors to the quality of cleansing. The bowel preparation agent should be administered, at least in part, a few hours in advance of the colonoscopy. Several low volume agents are available, and either new or modified schedules with PEG that usually improve tolerance. Certain adjuvants can also be used to reduce the volume of PEG, or to improve the efficacy of other agents. Other factors apart from the choice of agent can improve the quality of bowel cleansing. For instance, the effect of diet before colonoscopy has not been completely clarified, but an exclusively liquid diet is probably not required, and a low-fiber diet may be preferable because it improves patient satisfaction and the quality of the procedure. Some patients, such as diabetics and persons with heart or kidney disease, require modified procedures and certain precautions. Bowel preparation for pediatric patients is also reviewed here. In such cases, PEG remains the most commonly used agent. As detecting neoplasia is not the main objective with these patients, less intensive preparation may suffice. Special considerations must be made for patients with inflammatory bowel disease, including safety and diagnostic issues, so that the most adequate agent is chosen. Identifying neoplasia is one of the main objectives of colonoscopy with these patients, and the target lesions are often almost invisible with white light endoscopy. Therefore excellent quality preparation is required to find these lesions and to apply advanced methods such as chromoendoscopy. Bowel preparation for patients with lower gastrointestinal bleeding represents a challenge, and the strategies available are also reviewed here. Core tip: Bowel preparation for colonoscopy is a central issue related to the quality of the procedure. There are different agents for bowel preparation that can be administered with different schedules. We review the most commonly used agents, as well as new agents and combinations. Moreover, certain considerations should be taken into account for special populations in order to improve safety, efficacy and tolerance. Regimens for bowel preparation in special situations are discussed, such as for pedi...

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High‐ Versus Low‐Volume Polyethylene Glycol Plus Laxative Versus Sennosides for Colonoscopy Preparation in Children

Abstract: All 3 cleansing methods showed similar efficacy and tolerability; however, none of them was satisfactory.

Cited by 20 publications

References 27 publications

Bowel preparation in pediatric colonoscopy: results of an open observational study

Bowel preparation in pediatric colonoscopy: results of an open observational study

Inpatient burden of childhood functional GI disorders in the USA: an analysis of national trends in the USA from 1997 to 2009

Achieving the best bowel preparation for colonoscopy

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