Abstract

BackgroundPolyethylene 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.MethodsWe 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.Results32 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.ConclusionMiralax® 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 registrationTrial Registration Number: NCT02174497. Date of Registration: 02 May, 2014 URL of register: clinicaltrials.gov.

Highlights

  • Polyethylene Glycol 3350 (Miralax®) without electrolytes is commonly used for 3–4 days as bowel preparation for colonoscopy in children

  • This study aims to compare the efficacy and safety of a one-day preparation with that of a three-day preparation with Polyethylene Glycol (PEG) 3350 as preparation for colonoscopy in children and young adults

  • The importance of a safe, tolerable and effective colonoscopy preparation, in the pediatric population, is paramount for both diagnostic and, at times, therapeutic reasons. This is important for the patient in terms of acceptability and missed days of school and his/ her parents, in terms of taking time off of work. This is one of the first prospective studies evaluating the use of PEG 3350 without electrolytes for a one-day bowel preparation for colonoscopy in children and young adults in comparison with the three-day preparation

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Summary

Introduction

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. Colonoscopy in children and young adults is performed by gastroenterologists for a variety of indications, including but not limited to evaluation of rectal bleeding, chronic diarrhea, family history of polyposis syndromes and surveillance for colon cancer in patients with inflammatory bowel disease [1,2,3,4]. A successful bowel preparation that enables clear visualization of the intestinal mucosa is essential to diagnose and treat the underlying

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