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Polyethylene Glycol Versus Senna for Bowel Preparation for Colonoscopy in Children: Updated Evidence by a Systematic

Jun Watanabe1, Kazuhiko Kotani1

  • 1Community and Family Medicine, Jichi Medical University, Shimotsuke, JPN.

Cureus
|October 18, 2021
PubMed

Insights

Polyethylene glycol (PEG) bowel preparation is preferred over senna for pediatric colonoscopies, offering better results and less pain. Further research is recommended due to limited evidence for this important gastrointestinal procedure.

Area of Science:

  • Pediatric Gastroenterology
  • Endoscopic Procedures

Background:

  • Bowel preparation is crucial for pediatric colonoscopy, but evidence supporting agents like polyethylene glycol (PEG) and senna is limited.
  • Current practices for pediatric bowel preparation lack robust scientific grounding, necessitating evidence-based reviews.

Purpose of the Study:

  • To conduct a meta-analysis comparing different bowel preparation methods for pediatric colonoscopy.
  • To evaluate the efficacy and safety of polyethylene glycol (PEG) versus senna for colonoscopy in children.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) were performed.
  • Searches were conducted in electronic databases and trial registries up to April 2021.
  • Quality assessment utilized the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.

Main Results:

  • Three RCTs involving 318 pediatric patients were included.
  • Polyethylene glycol (PEG) demonstrated a preference over senna for bowel preparation (Risk Ratio [RR] 1.35, 95% Confidence Interval [CI] 1.05-1.74).
  • PEG was associated with significantly less pain compared to senna (RR 0.62, 95% CI 0.44-0.87), with no serious adverse events reported.

Conclusions:

  • Polyethylene glycol (PEG) may be a preferred agent for bowel preparation in pediatric colonoscopy.
  • The certainty of evidence is low to moderate, highlighting the need for more comprehensive studies.
  • Further research is essential to solidify evidence-based guidelines for pediatric bowel preparation.

Keywords:
child nursingcolon diseasepediatric practicepolyethylene glycolsenna

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