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Published on: August 1, 2019
Single versus split dose polyethylene glycol for bowel preparation in children undergoing colonoscopy: a systematic
Jinjin Cao1, Weiying Zhang2, Jiajie Hu3
1Department of Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Insights
Split dose polyethylene glycol (PEG) offers better acceptability and fewer side effects like nausea for pediatric bowel preparation compared to single dose PEG. Efficacy remains similar between the two regimens for children undergoing colonoscopy.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
- Pharmacology
Background:
- Polyethylene glycol (PEG) is a common agent for bowel preparation.
- The optimal dosing strategy (single vs. split dose) of PEG for pediatric colonoscopy requires further clarification regarding efficacy and safety.
Purpose of the Study:
- To systematically evaluate and compare the efficacy and safety of single-dose versus split-dose polyethylene glycol (PEG) for bowel preparation in children undergoing colonoscopy.
Main Methods:
- A systematic literature search of databases including PubMed was conducted up to September 1, 2019.
- Four randomized controlled trials (RCTs) involving 249 children were included in the meta-analysis.
- Data were synthesized using random-effects or fixed-effects models, with results expressed as odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI).
Main Results:
- No significant difference was found in the efficacy of bowel preparation between single-dose and split-dose PEG (OR = 0.36, 95% CI: -0.12 to 1.10).
- Split-dose PEG demonstrated significantly higher acceptability (OR = 0.50, 95% CI: 0.29 to 0.85) and a significantly lower incidence of nausea (OR = 2.1, 95% CI: 1.29 to 3.42) compared to single-dose PEG.
- There was no significant difference in the incidence of abdominal pain between the two dosing regimens (OR = 1.39, 95% CI: 0.67 to 2.89).
Conclusions:
- Split-dose PEG appears to be a superior regimen for bowel preparation in children undergoing colonoscopy due to improved acceptability and reduced nausea.
- The limited number of included RCTs necessitates further research to confirm these findings and solidify recommendations for pediatric bowel preparation.
Background:
Polyethylene glycol (PEG) has been widely used for bowel preparation. However, the efficacy and safety of single and split dose PEG for bowel preparation in children undergoing colonoscopy remain unclear, it is necessary to evaluate the role of single and split dose PEG for bowel preparation in children population.
Methods:
PubMed et al. databases up to September 1, 2019 were systematically searched. Randomized controlled trials (RCTs) single and split dose PEG for bowel preparation in children undergoing colonoscopy were included. Based on the heterogeneity, data were synthesized using random-effects or fixed-effects models. Results were expressed as Mantel-Haenszel style odds ratio (OR) or mean difference (MD) with 95% confidence interval (95% CI).
Results:
Four RCTs with 249 children were included. There was no significantly difference in the efficacy of single and split dose PEG for bowel preparation (OR =0.36, 95% CI: -0.12 to 1.10). The acceptability of split dose PEG for bowel preparation was significantly higher than that of single dose (OR =0.50, 95% CI: 0.29 to 0.85); the incidence of nausea in split dose PEG for bowel preparation was significantly lower than that of single dose (OR =2.1, 95% CI: 1.29 to 3.42); there was no significant difference on the incidence of abdominal pain between two regimes (OR =1.39, 95% CI: 0.67 to 2.89).
Conclusions:
Split dose PEG seems to be more superior to single dose for children undergoing colonoscopy. However, considering that the number of included RCTs are very limited, more related studies on this issue are needed in the future.
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