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[Intestinal cleaning for colonoscopy in children: effectiveness, adherence and adverse effects of schemes
Isabel Miquel1, María Eugenia Arancibia1, Francisco Alliende1
1Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile.
Insights
This study evaluated age-specific bowel preparation (BP) methods for pediatric colonoscopies. While most children had successful BP, effectiveness varied by age, with younger and older groups showing better results than the middle group.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
- Gastrointestinal Health
Background:
- Optimal colonoscopy requires effective bowel preparation (BP).
- Standardized BP protocols for pediatric patients are lacking.
- Age-specific BP strategies are needed for improved outcomes.
Purpose of the Study:
- To assess the effectiveness, adherence, and adverse effects of age-differentiated BP protocols in pediatric patients undergoing colonoscopy.
- To identify optimal BP strategies for different pediatric age groups.
Main Methods:
- A prospective study involving 159 pediatric patients (<18 years) undergoing colonoscopy.
- BP protocols were stratified by age: <6 months (glycerine suppository), 6 months-3 years (polyethylene glycol without electrolytes), 4-9 years (PEG without electrolytes + bisacodyl), and 10-18 years (PEG with electrolytes).
- Effectiveness was measured using the modified Boston Bowel Preparation scale; adherence and adverse events were recorded.
Main Results:
- 78% of patients achieved successful BP, with higher effectiveness in the <6 months (96%) and 10-18 years (91%) groups.
- The 4-9 years group showed lower effectiveness (69%) and higher constipation rates (29%).
- Adherence was good (87%), and adverse effects were mostly mild and transient.
Conclusions:
- Age-specific BP schemes demonstrated satisfactory results in pediatric colonoscopy preparation.
- Variations in effectiveness suggest the influence of age-related factors and prior bowel transit.
- The study supports tailored BP approaches for pediatric patients based on age.
Abstract:
Adequate intestinal cleanliness is crucial to achieve optimal colonoscopy performance. Several bowel preparation (BP) schemes have been proposed, but there is still no consensus as regards which is the most suitable in paediatric patients.
Objective:
To describe the effectiveness, adherence, and adverse effects of BP protocols differentiated by age group in paediatric patients subjected to colonoscopy.
Patients And Method:
Prospective, study that included patients < 18 years subjected to colonoscopy. BP protocols differentiated by age group were indicated as follows: < 6 m (glycerine suppository); 6 m-3y 11 m (poly-ethylene-glycol (PEG 3350 without electrolytes); 4y-9y 11 m (PEG 3350 without electrolytes + bisacodyl); 10 y-18 y (PEG 3350 with electrolytes). Demographic, clinical information, adherence and adverse effects were registered. Effectiveness was determined using a validated scale (Boston modified) during colonoscopy.
Results:
A total of 159 patients were included, of which 87 (55%) were males, and with a median age of 4 years (range 1 m-17 years). Seventy eight percent of patients achieved successful BP. The higher effectiveness was observed in the groups of < 6 m (96%) and 10-18 y (91%). Constipation was significantly more frequent (29%) in the 4 yo-9 yo 11 m in which lower effectiveness was observed (69%). Good adherence was observed in 87% of patients. Adverse effects were observed in a third of patients, although they were mild and did not lead to the suspension of the BP.
Conclusions:
Satisfactory results were achieved with the BP schemes used, with a successful BP being obtained in 4 out of 5 patients. Results were different between groups, which is probably related to previous bowel transit and indicated medication.
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