The Effectiveness, Tolerability, and Safety of Different 1-Day Bowel Preparation Regimens for Pediatric Colonoscopy. (3rd November 2019)

• Record Type: Journal Article
• Authors: Szaflarska-Popławska, Anna; Tunowska, Dominika; Sobieska-Poszwa, Ola; Gorecka, Anna; Krogulska, Aneta
• Other Names: Campana Davide Academic Editor.
• Is Part Of: Gastroenterology research and practice. Volume 2019(2019)
• Publication Date: 2019-11-03
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33005
• DOI: 10.1155/2019/3230654
• Languages: English
• ISSNs: 1687-6121

Abstract

Abstract : Background . Currently, there is no generally accepted universal protocol for bowel preparation before colonoscopy in children. Aim . The aim of the study was to compare three different 1-day bowel preparation methods for a pediatric elective colonoscopy in terms of their efficacy, safety, and patient-reported tolerability. Material and Methods . The study was randomized, prospective, and investigator-blinded. All children aged 10 to 18 years consecutively referred to the tertiary pediatric gastroenterology unit were enrolled. The participants were randomized to receive polyethylene glycol 3350 combined with bisacodyl (PEG-bisacodyl group), or polyethylene glycol 4000 with electrolytes (PEG-ELS group), or sodium picosulphate plus magnesium oxide plus citric acid (NaPico+MgCit group). Bowel preparation was assessed according to the Boston Bowel Preparation Scale (BBPS). For patient tolerability and acceptability, questionnaires were obtained. Results . One hundred twenty-three children were allocated to three age- and sex-matched groups. All of the patients completed colonoscopies with visualization of the cecum. There was no difference among the groups for the mean BBPS score. A total of 73 patients (59.3%) experienced minor adverse events. No serious adverse events occurred in any group. Nausea was the only symptom more frequent in the PEG-ELS group compared to the NaPico+MgCit group (p = 0.04 ), and apathy was the only symptom more frequent in PEG-bisacodyl than in the NaPico+MgCit group (p = 0.04 ). All of the patients were able to complete 75% or more of the study protocol, and 85.4% were able to complete the full regimen. The acceptability was the highest in the NaPico+MgCit group with respect to the patient's grade for palatability, low volume of the solution, and willingness to repeat the same protocol. Conclusion . All bowel cleansing methods show similar efficacy. However, because of the higher tolerability and acceptability profile, the NaPico+MgCit-based regimen appears to be the most proper for colonoscopy preparation in children.