DOI QR코드

DOI QR Code

Sodium Picosulphate with Magnesium Citrate versus Polyethylene Glycol for Bowel Preparation in Children: A Systematic Review

  • 투고 : 2021.12.13
  • 심사 : 2022.03.07
  • 발행 : 2022.05.15

초록

Purpose: To compare the effectiveness, tolerability, acceptability, and safety of sodium picosulphate with magnesium citrate (PS/Mg) and polyethylene glycol (PEG) in children (≤18 years) preparing for colonoscopy. Methods: Three electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) were searched till July 2020. Only randomized controlled trials (RCTs) were included. At least two authors independently selected studies and performed risk of bias assessment and data extraction. Results: Four RCTs (n=390), with overall good quality were included. A meta-analysis of two trials (n=224) found no statistically significant difference between the groups with respect to the proportion of patients who had excellent and good scores (≥6 points) according to the Boston Bowel Preparation Scale (relative risk: 0.99; 95% confidence interval [CI]: 0.90 to 1.08). Excellent and good scores were observed in both groups in approximately 90% of children. A meta-analysis of two other trials (n=150) showed no significant difference between the groups with respect to the mean total score for the Ottawa Bowel Preparation Scale (mean difference: 0.20; 95% CI: -0.74 to 1.14). Both regimens provided a comparable safety profile; however, PS/Mg was significantly superior to high volume PEG in terms of tolerability (abdominal pain, nausea, vomiting, bloating/flatulence/fullness) and acceptability (ease of formulation consumption, taste acceptance, need for nasogastric tube, compliance with full dose). Conclusion: PS/Mg provides a quality and safety profile similar to PEG for bowel cleansing; however, it has better acceptance and tolerance in children preparing for colonoscopy.

키워드

과제정보

The article was funded by The Medical University of Warsaw.

참고문헌

  1. ASGE Standards of Practice Committee, Lightdale JR, Acosta R, Shergill AK, Chandrasekhara V, Chathadi K, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc 2014;79:699-710. https://doi.org/10.1016/j.gie.2013.08.014
  2. Froehlich F, Wietlisbach V, Gonvers JJ, Burnand B, Vader JP. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc 2005;61:378-84. https://doi.org/10.1016/S0016-5107(04)02776-2
  3. Vejzovic V, Wennick A, Idvall E, Bramhagen AC. A private affair: children's experiences prior to colonoscopy. J Clin Nurs 2015;24:1038-47. https://doi.org/10.1111/jocn.12661
  4. Safder S, Demintieva Y, Rewalt M, Elitsur Y. Stool consistency and stool frequency are excellent clinical markers for adequate colon preparation after polyethylene glycol 3350 cleansing protocol: a prospective clinical study in children. Gastrointest Endosc 2008;68:1131-5. https://doi.org/10.1016/j.gie.2008.04.026
  5. Kierkus J, Horvath A, Szychta M, Woynarowski M, Wegner A, Wiernicka A, et al. High- versus low-volume polyethylene glycol plus laxative versus sennosides for colonoscopy preparation in children. J Pediatr Gastroenterol Nutr 2013;57:230-5. https://doi.org/10.1097/mpg.0b013e3182950ef5
  6. Gordon M, Karlsen F, Isaji S, Teck GO. Bowel preparation for elective procedures in children: a systematic review and meta-analysis. BMJ Paediatr Open 2017;1:e000118. https://doi.org/10.1136/bmjpo-2017-000118
  7. Tringali A, Thomson M, Dumonceau JM, Tavares M, Tabbers MM, Furlano R, et al. Pediatric gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Guideline Executive summary. Endoscopy 2017;49:83-91. https://doi.org/10.1055/s-0042-111002
  8. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009;6:e1000100. https://doi.org/10.1371/journal.pmed.1000100
  9. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA. Cochrane handbook for systematic reviews of interventions. 2nd ed. Chichester: John Wiley & Sons, 2019.
  10. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-34. https://doi.org/10.1136/bmj.315.7109.629
  11. Turner D, Benchimol EI, Dunn H, Griffiths AM, Frost K, Scaini V, et al. Pico-Salax versus polyethylene glycol for bowel cleanout before colonoscopy in children: a randomized controlled trial. Endoscopy 2009;41:1038-45. https://doi.org/10.1055/s-0029-1215333
  12. Di Nardo G, Aloi M, Cucchiara S, Spada C, Hassan C, Civitelli F, et al. Bowel preparations for colonoscopy: an RCT. Pediatrics 2014;134:249-56. https://doi.org/10.1542/peds.2014-0131
  13. Vejzovic V, Wennick A, Idvall E, Agardh D, Bramhagen AC. Polyethylene glycol- or sodium picosulphate-based laxatives before colonoscopy in children. J Pediatr Gastroenterol Nutr 2016;62:414-9. https://doi.org/10.1097/MPG.0000000000000978
  14. Szaflarska-Poplawska A, Tunowska D, Sobieska-Poszwa O, Krogulska A. The effectiveness, tolerability, and safety of different 1-day bowel preparation regimens for pediatric colonoscopy. Gastroenterol Res Pract 2019;2019:3230654. Erratum in: Gastroenterol Res Pract 2020;2020:9126957.
  15. Parmar R, Martel M, Rostom A, Barkun AN. Validated scales for colon cleansing: a systematic review. Am J Gastroenterol 2016;111:197-204; quiz 205. https://doi.org/10.1038/ajg.2015.417
  16. Hunter A, Mamula P. Bowel preparation for pediatric colonoscopy procedures. J Pediatr Gastroenterol Nutr 2010;51:254-61. https://doi.org/10.1097/mpg.0b013e3181eb6a1c
  17. Lagler FB, Hirschfeld S, Kindblom JM. Challenges in clinical trials for children and young people. Arch Dis Child 2021;106:321-5. https://doi.org/10.1136/archdischild-2019-318676
  18. van Lieshout I, Munsterman ID, Eskes AM, Maaskant JM, van der Hulst R. Systematic review and meta-analysis: Sodium picosulphate with magnesium citrate as bowel preparation for colonoscopy. United European Gastroenterol J 2017;5:917-43. https://doi.org/10.1177/2050640616684696