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1-day bowel preparation with polyethylene glycol 3350 is as effective and safe as a 3-day preparation for colonoscopy
Serge A Sorser1, Venkata Konanki, Alice Hursh
1Department of Gastroenterology, Providence Hospital and Medical Center, Southfield, MI, USA. ssorser@gmail.com.
Insights
A one-day bowel preparation using Polyethylene Glycol 3350 (Miralax®) is as safe and effective as a three-day regimen for pediatric colonoscopy. This shorter Miralax® preparation allows children to miss fewer school days.
Area of Science:
- Pediatric Gastroenterology
- Clinical Trial Research
- Medical Device Studies
Background:
- Polyethylene Glycol 3350 (Miralax®) is commonly used for pediatric colonoscopy preparation over 3-4 days.
- One-day Miralax® preparation is anecdotally effective but lacks robust comparative studies.
- This study aimed to compare the safety and efficacy of one-day versus three-day Miralax® bowel preparation in children.
Purpose of the Study:
- To compare the efficacy of one-day Miralax® bowel preparation against a three-day regimen for pediatric colonoscopy.
- To evaluate the safety and tolerability of a one-day Miralax® bowel preparation in children.
- To determine if a shortened preparation protocol impacts school attendance.
Main Methods:
- A prospective, randomized controlled trial was conducted involving children aged 2-21 years.
- Participants were randomized to receive Miralax® for one or three days.
- Efficacy was assessed via colonoscopic grading and stool diaries; safety was monitored through metabolic panels and side effect surveys.
Main Results:
- 32 subjects were enrolled (18 one-day, 14 three-day).
- No significant differences were found in bowel preparation efficacy or safety between the one-day and three-day groups.
- One-day Miralax® preparation was equally well-tolerated compared to the three-day regimen.
Conclusions:
- One-day Polyethylene Glycol 3350 (Miralax®) bowel preparation is a safe, effective, and well-tolerated option for pediatric elective colonoscopy.
- A one-day preparation regimen can reduce missed school days for pediatric patients.
- Healthcare providers should consider offering the one-day Miralax® preparation option.
Background:
Polyethylene Glycol 3350 (Miralax®) without electrolytes is commonly used for 3-4 days as bowel preparation for colonoscopy in children. One-day preparation has been anecdotally reported to be effective but there are few published prospective studies comparing the safety and efficacy of one-day preparation with that of three-day preparation. This study was conducted to compare the efficacy and safety of a one-day bowel preparation with Miralax® with that of a three-day preparation for colonoscopy in children.
Methods:
We conducted a prospective, randomized controlled trial with children age 2-21 yrs. undergoing elective colonoscopy. Patients were randomly assigned to receive Miralax® for either one or three days. Children with known electrolyte disturbances, dehydration, fecal impaction, metabolic or renal disease were excluded. A metabolic panel was monitored before and after bowel preparation. Subjects reported the tolerability and side effects of Miralax® via a survey. Effectiveness of the bowel preparation was assessed using a stool diary and a bowel cleansing scale during colonoscopy.
Results:
32 subjects were enrolled; 18 received one-day bowel preparation and 14 received 3-day preparation. There were no differences between the groups in efficacy of bowel preparation based on colonoscopic grading or the safety of the preparation. One-day preparation was as well tolerated as three-day preparation.
Conclusion:
Miralax® used one day as bowel preparation for elective colonoscopy in children is safe, effective and well tolerated. Physicians should consider offering a one-day option for bowel preparation, which would allow children to miss fewer days of school prior to colonoscopy.
Trial Registration Number:
NCT02174497. Date of Registration: 02 May, 2014 URL of register: clinicaltrials.gov.
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