Efficacy of Two Regimens for Colon Cleansing Using Polyethylene Glycol 4000: A Randomized Open Label Trial

Area of Science:

• Pediatric Gastroenterology
• Endoscopic Procedures
• Pharmacology

Background:

• Effective colon cleansing is crucial for successful pediatric colonoscopy.
• Polyethylene glycol (PEG) based regimens are commonly used for bowel preparation in children.
• Comparing different PEG formulations and adjuncts is important for optimizing pediatric care.

Purpose of the Study:

• To compare the effectiveness, safety, and tolerance of two distinct colon cleansing regimens in pediatric patients undergoing colonoscopy.
• Specifically, to evaluate a regimen of PEG with electrolyte plus oral bisacodyl (PEG+B) against a regimen of PEG with electrolyte plus a glycerol enema (PEG+G).

Main Methods:

• A prospective, randomized, open clinical trial involving 129 children aged 3 to 18 years.
• Participants were randomized to receive either PEG with electrolyte and oral bisacodyl or PEG with electrolyte and a glycerol enema.
• Colon cleansing success rates, laboratory values, and adverse events (nausea, bloating) were assessed.

Main Results:

• Both PEG+B and PEG+G regimens demonstrated high colon cleansing effectiveness (93.8% vs 89.1%, P=0.51).
• No significant differences in pre- and post-regimen laboratory values were observed between the groups.
• The PEG+G group experienced significantly higher rates of nausea (65.6% vs 31.3%) and bloating (50% vs 17.2%) compared to the PEG+B group (P<0.001 for both).

Conclusions:

• Both polyethylene glycol-based colon cleansing regimens are effective and safe for pediatric use.
• The PEG with bisacodyl regimen showed superior tolerance, with significantly lower incidence of nausea and bloating in children.