Barriers and Facilitators to a Good Bowel Preparation for Colonoscopy in Children: A Qualitative Study

Area of Science:

• Pediatric Gastroenterology
• Medical Procedures
• Patient Experience

Background:

• Adequate colon visualization during colonoscopy is essential for accurate diagnosis and reducing repeat procedures.
• Research on factors influencing bowel preparation quality has primarily focused on adult populations.
• Understanding pediatric-specific challenges is needed to optimize colonoscopy outcomes in children.

Purpose of the Study:

• To identify barriers and facilitators impacting the quality of bowel preparation in pediatric patients undergoing colonoscopy.
• To gather insights from children and parents regarding their experiences with home bowel preparation protocols.

Main Methods:

• A qualitative descriptive study involving children (2-18 years) and their parents recruited from a pediatric gastroenterology clinic.
• Semistructured interviews were conducted to assess understanding, compliance, and tolerability of bowel preparation.
• Thematic analysis was used to categorize identified barriers and facilitators.

Main Results:

• Eleven families participated, with 50% of children under 11 and 73% undergoing their first bowel preparation.
• Key barriers included confusion about preparation mixing, dietary restrictions, and unclear stool outcome expectations.
• Facilitators comprised accessible gastroenterology teams, smaller preparation volumes, minimal adverse effects, clear handouts, and parental motivation.

Conclusions:

• This study is the first qualitative investigation into pediatric home bowel preparation for colonoscopy.
• Findings highlight specific barriers and facilitators that can inform improvements in pediatric bowel preparation protocols.
• Optimizing the preparation process can enhance the overall colonoscopy experience and diagnostic yield in children.