Endoscopy 2018; 50(04): S100-S101
DOI: 10.1055/s-0038-1637326
ESGE Days 2018 ePoster Podium presentations
20.04.2018 – Colon cleansing
Georg Thieme Verlag KG Stuttgart · New York

LOW VOLUME VERSUS HIGH-VOLUME PREPARATION FOR BOWEL CLEANSING IN PEDIATRIC COLONOSCOPY

O Belei
1   University of Medicine and Pharmacy Victor Babes, First Pediatric Clinic, Timisoara, Romania
,
L Olariu
1   University of Medicine and Pharmacy Victor Babes, First Pediatric Clinic, Timisoara, Romania
,
T Marcovici
1   University of Medicine and Pharmacy Victor Babes, First Pediatric Clinic, Timisoara, Romania
,
O Marginean
1   University of Medicine and Pharmacy Victor Babes, First Pediatric Clinic, Timisoara, Romania
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Bowel preparation regimens for colonoscopy are not standardized in children. Optimal intestinal cleanliness is pivotal for safety and quality of pediatric colonoscopy. The objective was to compare the effectiveness and adherence of four different regimens of one day preparation for colonoscopy in children.

Methods:

We conducted a retrospective study that included all children aged between 3 months-18 years that were submitted to colonoscopy in the last year in our unit. Four methods for bowel cleansing were analyzed.

  1. high volume regimen with polyethylene glycol (PEG-4000) 100 ml/kg;

  2. PEG-4000 plus two normal saline enemas;

  3. low volume regimen with split administration of sodium picosulphate with magnesium citrate (SPMC) and

  4. SPMC plus two normal saline enemas.

Boston Bowel Preparation Score was used for evaluation of preparation. The regimens tolerance was assessed by parents/children using a questionnaire.

Results:

137 children achieved successful preparation. 35 received the first regimen, 47 used the second regimen, 24 used the third regimen and 31 received the fourth regimen. Excelent/good bowel preparation was achieved in 19 (54%), 41 (87%), 14 (58%) and 26 (84%) of cases in PEG, PEG+enemas, SPMC and SPMC+enemas group respectively. The highest effectiveness was observed among children that received regimens based on PEG-4000 or SPMC, associating two enemas one day prior to colonoscopy. There were no statistical differences between these groups (p = 0.7). Low and high-volume preparation combined with enemas provided a better cleanout compared to oral preparation alone (p = 0.001 and 0.002 respectively). The overall compliance for SPMC regimen was excellent (98%), compared to 71% for PEG-4000 regimen (p = 0.03). In 29% of cases the nasogastric tube was used for complete preparation with PEG-4000 due to adverse events such as: nausea, abdominal pain, vomiting.

Conclusions:

Low volume and high-volume preparation has similar efficacy in terms of bowel cleansing. Adding enemas increased the bowel cleansing rate. Low volume preparation is better tolerated in children.