Document Type
Article
Publication Date
11-7-2018
Identifier
PMCID: PMC6223084 DOI: 10.1186/s12876-018-0895-7
Abstract
BACKGROUND: The adequacy of pre-procedure preparation is the principal determinant of the quality of colonoscopy in pediatric as in adult patients. There is a lack of consensus, among providers on a standard pre-procedure regimen. Professional society guidelines include the use of Polyethylene glycol (PEG). Herein we report on the provider-assessed adequacy of a one day, age-categorized dosing, PEG based cleanout regimen in children undergoing colonoscopy in a tertiary institution.
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METHODS: The standard bowel preparation regime at our institution includes an age dependent minimum PEG dosing regimen in addition to clear liquids the day prior to the procedure. We retrospectively abstracted relevant indices including patient demographics, prep quality, procedure impairment, duration and completion from an institutional quality monitoring survey tool between 2015 and 2016 and similarly abstracted prospectively recorded indices that included the dataset above as well as additional fields for procedure deviations and additional laxative use.
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RESULTS: A total of 642 procedures (mean age 12.2 years; F: 380) were accrued, nonadherence to the cleanout regimen (7.3%) and additional laxative use (3.1%) were observed in a small proportion of the prospective dataset subjects, adequate cleanout defined as thin or thick liquid but no solids present was reported in 79.5% and 15.8% of cases and impaired study from inadequate cleanout was reported in 11.8% of studies albeit the cecum was reached and the terminal ileum was intubated in 97.8 and 93.6% of studies. The duration of the study was significantly longer with the presence of a fellow trainee assisting in the procedure. Patient age and gender did not correlate with prep adequacy or cecal and ileal intubation rates, inadequate cleanout was significantly associated with impairment and incomplete studies.
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CONCLUSION: A one day, single agent, osmotic laxative (Polyethylene glycol) based cleanout regimen is effective in routine pre-procedure cleanout for standard colonoscopy in pediatric age range patients.
Journal Title
BMC gastroenterology [electronic resource]
Volume
18
Issue
1
First Page
170
Last Page
170
MeSH Keywords
Administration, Oral; Adolescent; Age Factors; Cathartics; Child; Child, Preschool; Colonoscopy; Drug Administration Schedule; Female; Humans; Infant; Laxatives; Male; Patient Compliance; Polyethylene Glycols; Retrospective Studies; Young Adult
Keywords
Cleanout; Colonoscopy; Pediatric; Polyethylene glycol; Preparation; Quality
Recommended Citation
Kumar AS, Beutler BL, Attard TM. One-day oral polyethylene glycol based cleanout is effective for pre-colonoscopy preparation in children. BMC Gastroenterol. 2018;18(1):170. Published 2018 Nov 7. doi:10.1186/s12876-018-0895-7
Comments
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Publisher's Link: https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-018-0895-7