Related Experiment Videos
Safety, efficacy, and tolerance of intestinal lavage in pediatric patients undergoing diagnostic colonoscopy
J M Sondheimer1, R J Sokol, S F Taylor
1Department of Pediatrics, University of Colorado Health Sciences Center, Denver.
Insights
This study found that polyethylene glycol-3350 intestinal lavage solution is safe and effective for pediatric colonoscopy preparation. While some patients experienced mild side effects, the solution achieved clear stools efficiently in children.
Area of Science:
- Gastroenterology
- Pediatric Medicine
Background:
- Colonoscopy preparation in pediatric patients requires safe and effective intestinal lavage solutions.
- Polyethylene glycol (PEG)-based solutions are commonly used for bowel cleansing.
Purpose of the Study:
- To evaluate the safety, efficacy, and patient tolerance of an enterally administered isotonic intestinal lavage solution containing polyethylene glycol-3350 in pediatric patients undergoing diagnostic colonoscopy.
Main Methods:
- An open-label prospective study involving 20 pediatric patients (ages 1.5-19 years).
- Patients received metoclopramide followed by oral or nasogastric administration of PEG-3350 solution at 40 ml/kg/hour until clear stools were achieved.
- Colon preparation quality, adverse events, and physiological parameters were assessed.
Main Results:
- Clear stools were achieved in a mean of 2.6 hours. Colon preparation was optimal in 11 patients, satisfactory in 7, and suboptimal in 2.
- Adverse events included emesis (4 patients), nausea (11 patients), and abdominal distension (5 patients).
- Minor, transient decreases in urine osmolality, blood urea nitrogen, serum glucose, and potassium were observed. Mean weight change was minimal (+0.14 kg).
Conclusions:
- Whole intestinal perfusion with PEG-3350 solution is a safe, acceptable, and efficacious method for colonoscopy preparation in children.
- Patient tolerance was variable, with 11 patients requiring nasogastric administration due to taste.
- The solution demonstrated good efficacy in achieving adequate bowel preparation for diagnostic colonoscopy in this pediatric cohort.
Abstract:
In an open-label prospective study the safety, efficacy, and patient tolerance of an enterally administered isotonic intestinal lavage solution containing polyethylene glycol-3350 was evaluated in 20 pediatric patients (ages 1 1/2 to 19 years) undergoing diagnostic colonoscopy. After an oral dose of metoclopramide, lavage solution was administered by mouth or nasogastric tube at a rate of 40 ml/kg per hour until stools were clear. Emesis occurred in 4 patients, nausea in 11, and abdominal distension in 5. Clear stools were produced in a mean (+/- SE) time of 2.6 +/- 0.3 hours. The volume of lavage solution delivered, which ranged from 15.6 to 183.3 ml/kg, varied inversely with the weight (and age) of the patient. Preparation of the colon was considered optimal in 11 patients, satisfactory in 7, and suboptimal in 2. Small but significant decreases in urine osmolality, blood urea nitrogen, serum glucose, and potassium values were noted at the termination of perfusion. Postperfusion serum glucose concentration in the smallest patient (11.4 kg) was 61 mg/dL (3.4 mmol/L). Mean (+/- SEM) change in weight after perfusion was 0.14 +/- 0.05 kg (range -0.2 to +0.6 kg). Of 20 patients, 11 required or requested nasogastric administration of the lavage solution because of its unpleasant taste. We conclude that whole intestinal perfusion with a balanced electrolyte solution containing polyethylene glycol is safe, acceptable, and efficacious in children.