Feasibility and safety of bowel cleansing using low‐volume polyethylene glycol with ascorbic acid before pediatric colonoscopy: A pilot study

Tsunoda, Tomoyuki; Sogo, Tsuyoshi; Iwasawa, Kentaro; Umetsu, Shuichiro; Oikawa-Kawamoto, Manari; Inui, Ayano; Fujisawa, Tomoo

doi:10.1111/den.12756

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…Newer PEG-ELS preparations now contain ascorbic acid; this is more palatable and has a higher osmotic effect, allowing for half the required volume. A pilot retrospective study showed this to be an effective regimen in pediatrics, though these patients also received a dose of sodium picosulfate (13). PEG 3350 without electrolytes (e.g., Miralax R , Bayer Healthcare, Whippany, NJ), originally used for management of constipation and fecal impaction, is now the most commonly used bowel preparation.…”

Section: Polyethylene Glycolmentioning

confidence: 99%

Bowel Preparation for Pediatric Colonoscopy

Pall

Zacur

Krämer

et al. 2014

J. pediatr. gastroenterol. nutr.

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Pediatric bowel preparation protocols used before colonoscopy vary greatly, with no identified standard practice. The present clinical report reviews the evidence for several bowel preparations in children and reports on their use among North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition members. Publications in the pediatric literature for bowel preparation regimens are described, including mechanisms of action, efficacy and ease of use, and pediatric studies. A survey distributed to pediatric gastroenterology programs across the country reviews present national practice, and cleanout recommendations are provided. Finally, further areas for research are identified.

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Section: Polyethylene Glycolmentioning

confidence: 99%

Bowel Preparation for Pediatric Colonoscopy

Pall

Zacur

Krämer

et al. 2014

J. pediatr. gastroenterol. nutr.

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Section: Types Of Bowel Preparationmentioning

confidence: 99%

Bowel Preparation for Pediatric Colonoscopy

Mamula

Nema

2021

Front. Pediatr.

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Colonoscopy is an important diagnostic and therapeutic tool in evaluating and treating gastrointestinal tract pathologies. Adequate visualization of the intestinal lumen is necessary for detection of lesions, and thus bowel preparation is a key component of the process. It is estimated that over 25% percent of pediatric patients have sub-optimal bowel preparations, which can lead to longer procedure times, missed pathology, unsuccessful ileal intubation, and possibly repeat procedure/anesthesia. There is no universal protocol for bowel preparation in pediatrics and there is a wide variability of practices around the world. The purpose of this paper is to review the recent published literature regarding bowel preparations for pediatric colonoscopy with focus on published work in the last decade exploring a number of factors involved in bowel preparation including the role of patient education, types of bowel preparation, and their efficacy and safety.

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“…The drug of choice for bowel preparation is polyethylene glycol (PEG) due to its high efficacy, safety, and ease of use, as confirmed by several studies. Both adult and child guidelines recommend PEG as the preferred laxative for bowel preparation ( Pashankar et al., 2004 ; Safder et al., 2008 ; Pall et al., 2014 ; ASGE Standards of Practice Committee et al., 2015 ; Tsunoda et al., 2017 ; Mytyk et al., 2018 ). Split-dose PEG is commonly used for bowel preparation in adults before colonoscopy ( Samarasena et al., 2012 ; Zawaly et al., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Gut microbiota in children with split-dose bowel preparations revealed by metagenomics

Zou

Zeng

Chen

et al. 2023

Front. Cell. Infect. Microbiol.

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ObjectiveSplit-dose polyethylene glycol (PEG) is routinely used for bowel preparation before colonoscopy. This study aimed to investigate the composition of gut microbiota and its functions in pediatric patients undergoing split-dose PEG bowel preparation for colonoscopy to understand the stability and resilience of gut microbiota.Material and methodsFrom September to December 2021, 19 pediatric patients were enrolled at Shenzhen Children’s Hospital and 76 samples (4 time points) were analyzed using metagenomics. Time points included Time_1 (one day before bowel preparation), Time_2 (one day after colonoscopy), Time_3 (two weeks after bowel preparation), and Time_4 (four weeks after bowel preparation).ResultAlpha diversity comparison at both the species and gene levels showed a decrease in community richness after colonoscopy, with little statistical significance. However, the Shannon diversity index significantly decreased (P<0.05) and gradually returned to pre-preparation levels at two weeks after bowel preparation. The genus level analysis showed six genera (Eubacterium, Escherichia, Intertinibacter, Veillonella, Ruminococcaceae unclassified, and Coprobacillus) significantly different across the four time periods. Additionally, at the species level, the abundance of Escherichia coli, Bacteroides fragilis, and Veillonella parvula significantly increased at one day after colonoscopy before gradually decreasing at two weeks after bowel preparation. In contrast, the abundance of Intertinibacter bartlettii decreased at one day after colonoscopy but then recovered at two weeks after bowel preparation, reaching the preoperative level at four weeks after bowel preparation. Furthermore, five functional pathways (base excision repair, biosynthesis of ansamycins, biosynthesis of siderophore group nonribosomal peptide, flavonoid biosynthesis, and biosynthesis of type II polyketide products) were significantly different across the four time periods, with recovery at two weeks after bowel preparation and reaching preoperative levels at four weeks after bowel preparation.ConclusionsGut microbiota at the genus level, species level, and functional pathways are impacted in pediatric patients undergoing split-dose PEG bowel preparation and colonoscopy, with recovery two weeks following bowel preparation. However, the phylum level was not impacted. Modifications in gut microbiota composition and function may be investigated in future studies of bowel preparation. This study highlights the stability and resilience of gut microbiota among pediatric patients during bowel preparation.

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Feasibility and safety of bowel cleansing using low‐volume polyethylene glycol with ascorbic acid before pediatric colonoscopy: A pilot study

Abstract: Same-day regimen of polyethylene glycol solution with ascorbic acid is effective and safe for bowel cleansing in children.

Cited by 6 publications

References 18 publications

Bowel Preparation for Pediatric Colonoscopy

Bowel Preparation for Pediatric Colonoscopy

Bowel Preparation for Pediatric Colonoscopy

Gut microbiota in children with split-dose bowel preparations revealed by metagenomics

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