Journal of Pediatric Gastroenterology and Nutrition:
October 2005 - Volume 41 - Issue 4 - p 559
Abstracts: North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Annual Meeting October 20-22, 2005 Salt Lake City, Utah: MEDICAL STUDENT AND PEDIATRIC RESIDENT ABSTRACT PRESENTATIONS SUNDAY, OCTOBER 22, 2005 3:45PM - 5:45PM
Background:
Inadequate colon preparation is a significant obstacle in performing colonoscopy, and is directly related to poor patient compliance. Recently, a lavage solution (PEG 3350, Miralax) was found adequate for colon preparation in children (J Pediatr 2004).
Objective:
(1) To assess Miralax solution for colon preparation in children over an extended weekend. (2) Assess the value of clinical markers to predict adequate colon cleaning.
Methods:
In a prospective study, children scheduled for colonoscopy were prepared with Miralax solution (1.5 gms/kg/day, <100 g/day) for 4 days with no adjunct medications or enemas. Patients completed a questionnaire which included demographic data, amount (g) consumed, #stools/day, stool consistency, and side effects. Colon preparation was assessed immediately after colonoscopy procedure using a standard colon assessment: Grade 1: poor, Grade 2: fair, Grade 3-5: adequate/ excellent (Gastrointest Endo 2002).
Results:
99 children were included in the study with a mean age of 11.9 yrs. Side effects were seen in 31 children (29 abdominal pain, 4-vomiting). Seven children were excluded for protocol deviation. Colon preparation was found to be adequate to excellent (grade3-5) in 72 (84%) children, and poor to fair (grade1-2) in 15 (16%) children. Liquid stool consistency on days 3 & 4 was significantly associated with adequate (grade >3) colon preparation (p < 0.012: Sen-96%, PPV-87%). Average stool number above 5 per day within the last two days was significantly associated with adequate (grade >3) colon preparation (p < 0.038, Sen-60%, PPV-92%).
Conclusion:
1. Liquid stool consistency and number of stools averaging over 5 per day, in the last 2 days of preparation, are good markers for adequate colon preparation in children undergoing colonoscopy. 2. These markers may predict colon preparation prior to procedure and may reduce incomplete colonoscopy in children. 3. Weekend colon preparation with Miralax is safe and has excellent compliance in children undergoing colonoscopy procedure.
© 2005 Lippincott Williams & Wilkins, Inc.