1-day bowel preparation with polyethylene glycol 3350 is as effective and safe as a 3-day preparation for colonoscopy in children

Serge A Sorser, Venkata Konanki, Alice Hursh, Karen Hagglund, Hernando Lyons, Serge A Sorser, Venkata Konanki, Alice Hursh, Karen Hagglund, Hernando Lyons

Abstract

Background: Polyethylene Glycol 3350 (Miralax®) without electrolytes is commonly used for 3-4 days as bowel preparation for colonoscopy in children. One-day preparation has been anecdotally reported to be effective but there are few published prospective studies comparing the safety and efficacy of one-day preparation with that of three-day preparation. This study was conducted to compare the efficacy and safety of a one-day bowel preparation with Miralax® with that of a three-day preparation for colonoscopy in children.

Methods: We conducted a prospective, randomized controlled trial with children age 2-21 yrs. undergoing elective colonoscopy. Patients were randomly assigned to receive Miralax® for either one or three days. Children with known electrolyte disturbances, dehydration, fecal impaction, metabolic or renal disease were excluded. A metabolic panel was monitored before and after bowel preparation. Subjects reported the tolerability and side effects of Miralax® via a survey. Effectiveness of the bowel preparation was assessed using a stool diary and a bowel cleansing scale during colonoscopy.

Results: 32 subjects were enrolled; 18 received one-day bowel preparation and 14 received 3-day preparation. There were no differences between the groups in efficacy of bowel preparation based on colonoscopic grading or the safety of the preparation. One-day preparation was as well tolerated as three-day preparation.

Conclusion: Miralax® used one day as bowel preparation for elective colonoscopy in children is safe, effective and well tolerated. Physicians should consider offering a one-day option for bowel preparation, which would allow children to miss fewer days of school prior to colonoscopy.

Trial registration number: NCT02174497. Date of Registration: 02 May, 2014 URL of register: clinicaltrials.gov.

References

    1. Hassall E, Barclay GN, Ament ME. Colonoscopy in childhood. Pediatrics. 1984;73(5):594–9.
    1. Sasaki H, Yagucji T, Hasegawa K, Lee B, Noguchi T, Nagasako K. Pediatric colonoscopy. Dis Colon Rectum. 1981;24(4):257–8. doi: 10.1007/BF02641871.
    1. Fox VL. Pediatric endoscopy. Gastrointest Endosc Clin N Am. 2000;10(1):175–94.
    1. Wyllie R, Kay MH. Colonoscopy and therapeutic intervention in infants and children. Gastrointest Endosc Clin N Am. 1994;4(1):143–60.
    1. Panshankar DS, Uc A, Bishop WP. Polyethylene glycol 3350 without electrolytes: a new, safe, effective, and palatable bowel preparation for colonoscopy in children. J Pediatr. 2004;144(3):358–62. doi: 10.1016/j.jpeds.2003.11.033.
    1. Hunter A, Mamula P. Bowel preparation for pediatric colonoscopy procedures. J Pediatr Gastroenterol Nutr. 2010;51(3):246–61.
    1. Barkun A, Chiba N, Enns R, Marcon M, Natsheh S, Pham C, Sadowski D, Vanner S. Commonly used preparations for colonoscopy: efficacy, tolerability, and safety–a Canadian association of gastroenterology position paper. Can J Gastroenterol. 2006;20(11):699–710.
    1. Phatak UP, Johnson S, Husain SZ, Pashankar DS. Two-day bowel preparation with polyethylene glycol 3350 and bisacodyl: a new, safe, and effective regimen for colonoscopy in children. J Pediatr Gastroenterol Nutr. 2011;53(1):71–4. doi: 10.1097/MPG.0b013e318210807a.
    1. Dahshan A, Lin C, Peters J, Thomas R, Tolia V. A randomized, prospective study to evaluate the efficacy and acceptance of three bowel preparations for colonoscopy in children. Am J Gastroenterol. 1999;94:3497–501. doi: 10.1111/j.1572-0241.1999.01613.x.
    1. Gremse D, Sacks A, Raines S. Comparison of oral sodium phosphate to polyethylene glycol-based solution for bowel preparation for colonoscopy in children. J Pediatr Gastroenterol Nutr. 1996;23:586–90. doi: 10.1097/00005176-199612000-00013.
    1. Barrish J, Gilger M. Colon cleanout preparations in children and adolescents. Gastroenterol Nurs. 1993;16:106–9. doi: 10.1097/00001610-199312000-00004.
    1. Adamiak T, Altaf M, Jensen MK, Sultan M, Ramprasad J, Ciecierega T, Sherry K, Miranda A, Sultan M, Ramprasad J, Ciecierega T, Sherry K, Miranda A. One-day bowel preparation with polyethylene glycol 3350: an effective regimen for colonoscopy in children. Gastrointest Endosc. 2010;71(3):573–7. doi: 10.1016/j.gie.2009.10.042.
    1. Walia R, Steffen R, Feinberg L, Worley S, Mahajan L. J Pediatr Gastroenterol Nutr. 2012. The tolerability, safety and efficacy of PEG 3350 as a One Day bowel preparation in children.
    1. Abbas MI, Nylund CM, Bruch CJ, Nazareno LG, Rogers PL. J Pediatr Gastroenterol Nutr. 2012. Prospective evaluation of One-Day polyethylene glycol-3350 bowel preparation regimen in children.
    1. Enestvedt BK, Tofani C, Laine LA, Tierney A, Fennerty MB. 4-liter split-dose polyethylene glycol is superior to other bowel preparations, based on systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2012;10(11):1225–31. doi: 10.1016/j.cgh.2012.08.029.
    1. Gurudu SR, Ramirez FC, Harrison ME, Leighton JA, Crowell MD. Increased adenoma detection rate with system-wide implementation of a split-dose preparation for colonoscopy. Gastrointest Endosc. 2012;76(3):603–8. doi: 10.1016/j.gie.2012.04.456.
    1. Seo EH, Kim TO, Kim TG, Joo HR, Park MJ, Park J, Park SH, Yang SY, Moon YS. Efficacy and tolerability of split-dose PEG compared with split-dose aqueous sodium phosphate for outpatient colonoscopy: a randomized, controlled trial. Dig Dis Sci. 2011;56(10):2963–71. doi: 10.1007/s10620-011-1772-1.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere