Whole bowel irrigation in pediatric patients: a comparison of irrigating solutions

Area of Science:

• Pediatric Gastroenterology
• Clinical Nutrition
• Internal Medicine

Background:

• Whole bowel irrigation (WBI) is a common procedure for gastrointestinal cleansing in children.
• Previous methods using electrolytic solutions like normal saline (NS) or Ringer's injection (RI) have been associated with adverse effects.
• The efficacy and safety of polyethylene glycol electrolyte lavage solution (PEG-ELS) in pediatric WBI require further evaluation.

Purpose of the Study:

• To compare the effectiveness and safety of WBI using PEG-ELS versus electrolytic solutions (NS and RI) in children.
• To assess parameters such as volume, time, weight changes, hemodilution, and electrolyte balance.
• To determine the preferred WBI solution for pediatric patients.

Main Methods:

• A comparative study involving three groups of children undergoing WBI.
• Group 1: WBI with PEG-ELS (27 children).
• Group 2: WBI with NS (25 children).
• Group 3: WBI with RI (29 children).
• Monitoring of volume, duration, weight, and biochemical parameters.

Main Results:

• PEG-ELS required significantly less volume and time for WBI compared to NS and RI.
• Children receiving PEG-ELS did not experience weight gain, unlike those treated with electrolytic solutions.
• PEG-ELS did not lead to hemodilution or hyperchloremia, which were observed with NS and RI.
• No significant differences in efficacy of bowel cleansing were implied, but safety and tolerability favored PEG-ELS.

Conclusions:

• A balanced PEG-ELS is the preferred solution for whole bowel irrigation in children.
• PEG-ELS offers a safer and more efficient alternative to traditional electrolytic solutions for pediatric WBI.
• This finding supports the optimization of gastrointestinal preparation in pediatric care.