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Bowel preparation for pediatric colonoscopy: report of the NASPGHAN endoscopy and procedures committee

Harpreet Pall1, George M Zacur, Robert E Kramer

  • 1*Section of Gastroenterology, Hepatology, and Nutrition, St Christopher's Hospital for Children, Philadelphia, Pennsylvania †Division of Pediatric Gastroenterology, University of Michigan Health System, Ann Arbor ‡Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital Colorado, Aurora §Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Nebraska Medical Center/Children's Medical Center, Omaha ||Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts ¶Division of Pediatric Gastroenterology, Loma Linda University, Loma Linda, California #Division of Pediatric Gastroenterology, University of Louisville, Louisville, Kentucky **Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Broward Health Medical Center, Fort Lauderdale, Florida ††Division of Pediatric Gastroenterology and Nutrition, Arkansas Children's Hospital, Little Rock ‡‡Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania §§Division of Gastroenterology, Phoenix Children's Hospital, Phoenix, Arizona ||||Division of Pediatric Gastroenterology, Medical University of South Carolina, Charleston ¶¶Division of Gastroenterology, Hepatology, and Nutrition, Texas Children's Hospital, Houston.

Journal of Pediatric Gastroenterology and Nutrition
|June 5, 2014
PubMed

Insights

Pediatric bowel preparation before colonoscopy lacks a standard. This report reviews evidence and current practices to provide cleanout recommendations for children undergoing the procedure.

Area of Science:

  • Pediatric Gastroenterology
  • Endoscopy
  • Clinical Practice Guidelines

Background:

  • Bowel preparation protocols for pediatric colonoscopy exhibit significant variability.
  • There is a lack of a standardized approach to preparing children for colonoscopy.

Purpose of the Study:

  • To review existing evidence on pediatric bowel preparation regimens.
  • To report on current practices among North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition members.
  • To provide evidence-based cleanout recommendations for pediatric colonoscopy.

Main Methods:

  • Literature review of pediatric bowel preparation studies, focusing on mechanism, efficacy, and usability.
  • A survey distributed to pediatric gastroenterology programs nationwide to assess current practices.
  • Analysis of survey data to identify national trends and variations.

Main Results:

  • Significant heterogeneity exists in current pediatric bowel preparation protocols.
  • Evidence for various regimens, including their effectiveness and ease of use, is presented.
  • National practice patterns reveal diverse approaches to pediatric colonoscopy preparation.

Conclusions:

  • Standardized pediatric bowel preparation guidelines are needed.
  • Recommendations are provided to optimize bowel cleansing in children.
  • Further research is necessary to refine pediatric bowel preparation techniques.

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