High- versus low-volume polyethylene glycol plus laxative versus sennosides for colonoscopy preparation in children

Area of Science:

• Gastroenterology
• Pediatric Endoscopy
• Pharmacology

Background:

• Bowel preparation is crucial for pediatric colonoscopy.
• Existing protocols lack universal acceptance and optimal efficacy in children.
• Comparative studies are needed to determine the best bowel cleansing agents for pediatric patients.

Purpose of the Study:

• To compare the efficacy and acceptability of three bowel preparation regimens in children aged 10-18 years.
• To evaluate high-volume polyethylene glycol (PEG) against low-volume PEG with bisacodyl (BPEG) and sennosides.
• To provide data for optimizing pediatric colonoscopy preparation protocols.

Main Methods:

• A randomized controlled trial involving 234 pediatric patients (ages 10-18).
• Three groups received: high-volume PEG, low-volume PEG with bisacodyl, or sennosides for two days.
• Bowel cleansing was assessed blindly using the Aronchick and Ottawa scales; patient acceptability was measured via visual-analog scale.

Main Results:

• No significant differences in bowel cleansing efficacy were observed among the PEG, BPEG, and sennosides groups based on Aronchick and Ottawa scales.
• Excellent/good bowel preparation rates were similar across all three groups.
• Patient acceptability of the bowel cleansing protocols was comparable across all treatment arms (P=0.8).

Conclusions:

• High-volume PEG, BPEG, and sennosides demonstrate similar efficacy and tolerability for pediatric bowel preparation.
• Despite comparable results, none of the evaluated bowel cleansing methods achieved satisfactory outcomes in the pediatric population.
• Further research is warranted to develop more effective and acceptable bowel preparation strategies for children undergoing colonoscopy.