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Published on: August 1, 2019

Evidence-based recommendations for bowel cleansing before colonoscopy in children: a report from a national working

D Turner1, A Levine, B Weiss

  • 1Pediatric Gastroenterology and Nutrition Unit, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel. turnerd@szmc.org.il

Endoscopy
|July 30, 2010
PubMed

Insights

Developing evidence-based pediatric bowel cleansing guidelines is crucial. This study proposes several age-stratified protocols to optimize colonoscopy preparation and minimize adverse events in children.

Area of Science:

  • Pediatric Gastroenterology
  • Endoscopy Procedures
  • Evidence-Based Medicine

Background:

  • No established guidelines exist for pediatric bowel cleansing before colonoscopy.
  • The Israeli Society of Pediatric Gastroenterology and Nutrition (ISPGAN) formed a working group to address this gap.

Purpose of the Study:

  • To develop evidence-based guidelines for pediatric bowel cleansing.
  • To optimize colonoscopy preparation and minimize adverse events in children.

Main Methods:

  • Systematic literature review and a national survey of Israeli endoscopy units.
  • Consensus reached on six recommended protocols based on evidence strength.
  • Guidelines finalized after an open audit of ISPGAN members.

Main Results:

  • Data from 900 pediatric colonoscopies annually in Israel analyzed.
  • Proposed age-stratified protocols include PEG-ELS, Picolax, sodium phosphate (for older children), stimulant laxatives, and PEG 3350.
  • Estimated acute toxicity rate for sodium phosphate is low (0.041%).

Conclusions:

  • No single ideal bowel cleansing regimen exists for children.
  • Several evidence-based protocols are proposed to improve pediatric colonoscopy preparation.
  • The guidelines aim to optimize cleansing and reduce adverse events.
Abstract

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