The Utility of PEG3350 without Electrolytes for 2-Day Colonoscopy Preparation in Children

Jibaly, Rima; LaChance, Jenny; Lecea, Nicolas A.; Ali, Nasim; Weber, Jon

doi:10.1055/s-0031-1280822

Cited by 23 publications

(23 citation statements)

References 10 publications

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“…In published studies the preparation time seems to have an important influence on the cleaning result. Especially when PEG is used, longer preparation periods of 2 to 4 days have a tendency to yield better cleaning results 10 17, while the rate of good to excellent results in 1-day regimens does not exceed 88 % 19. When sodium picosulphate is used, up to 100 % of good to excellent cleaning is reported 18, but it should be noted that according to our results, no difference in terms of effectiveness could be found in 2 single-center randomized controlled trials directly comparing PEG and sodium picosulphate 20 21.…”

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: 88%

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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%

Section: Introductionmentioning

confidence: 88%

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

Berger¹,

Claßen

Engelhardt³

et al. 2016

Endosc Int Open

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“…Owing to the disadvantages of multiple day preparations such as poor compliance particularly in children, and disturbed daily activities, short-term PEG regimens were reported soon thereafter [19,20]. Lately, 1-day PEG-3350 regimens, administered in various doses and dissolved in maximum of 2 L fluid has become widely accepted by the pediatric gastroenterologists [8,9].…”

Section: Discussionmentioning

confidence: 99%

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

Tutar

Bayrak

Volkan

et al. 2019

Dig Dis

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Background and Objectives: Bowel preparation (BP) for colonoscopy is a challenging procedure in children and different regimens have been used for this purpose. Polyethylene glycol (PEG) is the most preferred agent in recent years. The primary aim of this study was to evaluate the efficacy of 1-day PEG-3350 with bisacodyl (PEG-B) and comparing it with 3-day sennosides A+B. Method: In this prospective, randomized, and single-blinded study, children aged 2–18 years were included in the PEG-B group for 1 day or in Senna group for 3 days. The effectiveness of BP was assessed according to the Ottawa and Boston BP scales, compliance and adverse effects were also recorded. Pre- and post-preparation biochemistry were obtained for investigation of safety of both regimens. Results: Successful BP was observed in 88.3% (n = 53/60) of PEG-B and 86% (n = 55/64) of Senna groups according to Boston scale, and it was 85% (n = 51/60) and 84.4% (n = 54/64), respectively, according to Ottawa scale. The cecal intubation rate was 96.7% (n = 58/60) in the PEG-B group and 93.8% (n = 60/64) in the Senna group. Ease of administration and disturbance in regular daily activities was better in the PEG-B group (p < 0.05). There was no major adverse event and biochemical abnormality in both groups. The correlation between Ottawa and Boston scales was found to be excellent (r² = –0.954, p < 0.01). Conclusions: The efficacy, safety, and adverse effect profile of 1-day BP with PEG-B regimen was found to be similar to 3-day sennosides regimen, however, the PEG-B regimen had advantages such as short duration, ease of administration, and better patient comfort. Also, high correlation rate between the Boston and Ottawa scales in pediatric patients was remarkable.

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“…However, bowel preparation should ideally be done in a shorter period of time. To establish an effective dose of PEG, a prospective study determined that 1.9 g/kg per day for 2 d with a clear-liquid diet resulted in clear stools in > 90% of patients with excellent/good Aronchick scores [151] . Another prospective study evaluated a 2-d PEG preparation with 2 g/kg per day PEG with bisacodyl supplementation [152] .…”

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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The Utility of PEG3350 without Electrolytes for 2-Day Colonoscopy Preparation in Children

Abstract: PEG3350 without electrolytes appears to be safe, effective, and well tolerated as a 2-day clean out for colonoscopy preparation in children with an average dose of 1.90 g/kg/day.

Cited by 23 publications

References 10 publications

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

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

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

Achieving the best bowel preparation for colonoscopy

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