Study to determine guidelines for pediatric colonoscopy

Abstract

AIMTo investigated characteristics, diagnosis, bowel-cleansing preparation, sedation, and colonoscope length and diameter in Japanese pediatric patients receiving total colonoscopy.METHODSThe present study evaluated consecutive patients aged ≤ 15 years who had undergone their first colonoscopy in Kurume University between January 2007 and February 2015. Data were retrospectively analyzed. We identified 110 pediatric patients who had undergone colonoscopy that had reached the cecum, allowing the observation of the total colon.RESULTSHematochezia, abdominal pain, and diarrhea were the most common symptoms. For bowel-cleansing preparation, pediatric patients aged ≤ 12 years were treated with magnesium citrate, and patients aged 13-15 years were treated with polyethylene glycol 4000. For sedation, thiamylal with pentazocine, which has an analgesic effect, was used in patients aged ≤ 6 years, and midazolam with pentazocine was used in patients aged ≥ 7 years. Regarding the choice of endoscope, short and thin endoscopes were selected for younger patients, particularly patients aged ≤ 3 years. Positive diagnoses were made in 78 patients (70.9%). Inflammatory bowel disease (n = 49, 44.5%), including ulcerative colitis (n = 37, 33.6%) and Crohn’s disease (n = 12, 10.9%), was the most common diagnosis.CONCLUSIONColonoscopy offers a high diagnostic capability for pediatric patients with gastrointestinal symptoms. The selection of appropriate management the performance of colonoscopy is important in pediatric patients.

Current role of colonoscopy in infants and young children: a multicenter study

“…The proportion of colonoscopies performed in infants and young children was 32.0% of the 1417 colonoscopies recorded in children aged 18 years old or younger. A cursory review of the literature revealed that this rate was higher than those in other previous studies on the subject of pediatric colonoscopy [12, 13]. We suggest two reasons for this findings; first, our three institutions are the tertiary children’s hospitals having pediatric anesthesia, and second, colonoscopies in children aged 15 to 18 years old in Japan are most often performed by gastroenterologists in adult units.…”

“…Our results demonstrate that 75% of children who underwent colonoscopy had rectal bleeding as a primary indication at diagnosis. We similarly found that rectal bleeding was the most common presentation for colonoscopies in all aged children in other recent reports [12, 15]. In this study, we compared the disease distribution in children younger than two years old with that in children with aged to two to five years old with reference to the pediatric Paris classification for IBD, because the number of IBD children has sharply increased in Japan.…”

Effect of music and toys on reducing pain during colonoscopy and acceptance of colonoscopy by children: a randomized clinical trial

“…This diagnostic and therapeutic tool is also used in children and infants to evaluate and treat diarrhea, weight loss, abdominal pain, anemia associated with iron deficiency and rectal bleeding. The main concern during this process, which lasts 20 to 30 minutes, is the pain and fear of colonoscopy, resulting in a lack of cooperation between the children (8)(9)(10). Several techniques, including the use of sedatives, nitric oxide, carbon dioxide, hypnosis, and music therapy have been used to reduce pain and anxiety during this procedure (11,12).…”

Pediatrik Hastalarda Kolonoskopide Sedasyon

“…Pediatrik Gastrointestinal (Gİ) hastalıklarda tanı ve tedavi amaçlı gerçekleştirilen Gİ endoskopik işlemler, ağrılı ve hoş olmayan girişimler olduğundan sedasyon ve analjezinin sağlanması her zaman önemli bir bileşen olmuştur (1). Özellikle pediatrik yaş grubu hastalar hem herhangi bir tıbbi işlemden gereğinden fazla korkmakta, hem de aşırı tepkiler verebildiği için hekimin rahat çalışamamasına neden olmaktadır.…”