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Bowel Preparation Outcomes Using Low-Volume Polyethylene Glycol With Selective Rescue Enema in Pediatric Colonoscopy

Tomohiro Ida1, Hayato Yamaguchi1,2, Masakatsu Fukuzawa1

  • 1Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|June 9, 2026
PubMed

Insights

Reduced-volume polyethylene glycol (PEG) with rescue enemas ensures effective pediatric bowel preparation for colonoscopy. This approach improves cleansing adequacy despite challenges with high-volume PEG tolerance in children.

Area of Science:

  • Pediatric Gastroenterology
  • Endoscopy Procedures
  • Gastrointestinal Motility

Background:

  • Pediatric colonoscopy preparation is difficult due to poor tolerance of high-volume polyethylene glycol (PEG).
  • Investigating reduced-volume PEG and rescue enemas for improved bowel cleansing in children.

Purpose of the Study:

  • To evaluate the effectiveness of reduced-volume PEG in pediatric bowel preparation.
  • To assess the clinical utility of rescue enemas for incomplete PEG ingestion.

Main Methods:

  • Retrospective review of 158 pediatric patients (≤15 years) undergoing colonoscopy.
  • Analysis of demographics, PEG volume, vomiting, taste intolerance, and enema use.
  • Bowel cleanliness assessed using Boston (BBPS) and Ottawa Bowel Preparation Scales (OBPS).

Main Results:

  • Reduced-volume PEG (37.9 mL/kg) achieved 98.1% cleansing adequacy (BBPS ≥6).
  • Vomiting (11.4%) and taste intolerance (42.4%) were noted; younger age and taste intolerance increased vomiting risk.
  • Rescue enemas were used in 48.7% of patients, maintaining adequate cleansing despite incomplete PEG intake.

Conclusions:

  • Low-volume PEG is effective for pediatric bowel cleansing.
  • Rescue enemas are practical for managing incomplete PEG intake.
  • Optimizing PEG tolerability and using rescue measures are crucial for pediatric bowel preparation.
Abstract

Keywords:
bowel preparationenemapediatric colonoscopypolyethylene glycolvomiting

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