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Bowel preparations for colonoscopy: an RCT.

Giovanni Di Nardo1, Marina Aloi2, Salvatore Cucchiara2

  • 1Departments of Pediatrics, Pediatric Gastroenterology Unit, and giovanni.dinardo@uniroma1.it.

Pediatrics
|July 9, 2014
PubMed
Summary

Four pediatric colonoscopy bowel preparations were compared. Low-volume polyethylene glycol (PEG) and sodium picosulfate/magnesium citrate regimens were as effective as standard PEG-ELS, with better tolerability and acceptance.

Keywords:
childrencolon cleansingcolonoscopy

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Area of Science:

  • Pediatric Gastroenterology
  • Colorectal Surgery
  • Endoscopy

Background:

  • Pediatric colonoscopy preparation is challenging.
  • Current bowel cleansing agents have limitations for children.

Purpose of the Study:

  • Compare efficacy, safety, tolerability, and acceptance of four pediatric bowel preparation methods.
  • Identify optimal bowel cleansing regimens for pediatric colonoscopy.

Main Methods:

  • Randomized, investigator-blinded, noninferiority trial.
  • Children (2-18 years) received PEG 4000 with simethicon (PEG-ELS), PEG-4000 with citrates/simethicone/bisacodyl (PEG-CS+Bisacodyl), PEG 3350 with ascorbic acid (PEG-Asc), or sodium picosulfate/magnesium citrate (NaPico+MgCit).
  • Bowel cleansing assessed by Boston Bowel Preparation Scale; tolerability, acceptability, and compliance evaluated.

Main Results:

  • Three hundred patients randomized.
  • PEG-CS+Bisacodyl, PEG-Asc, and NaPico+MgCit were noninferior to PEG-ELS for overall colon cleansing.
  • No serious adverse events; NaPico+MgCit showed significantly higher tolerability, acceptability, and compliance.

Conclusions:

  • Low-volume PEG and NaPico+MgCit preparations are effective alternatives to high-volume PEG-ELS in children.
  • NaPico+MgCit is the most suitable regimen due to superior tolerability and acceptance.