Bowel preparation in children and adolescents undergoing ileo-colonoscopy: what is new?

Abstract

Ileo-colonoscopy is a vital diagnostic and therapeutic tool undertaken for evaluating and treating gastrointestinal tract pathologies in children and adolescents as well as adults. Proper visualization of the lower intestinal mucosa, completion of the procedure including terminal ileum/cecal intubation, detection of pathological lesions and therapeutic maneuvers are hinged on how adequate the bowel preparation is. About 25% percent of pediatric patients have inadequate bowel preparations, which can lead to prolonged colonoscopy procedure time, missed pathology, difficult ileal intubation/incomplete examination, and requiring cancellation or repeat procedure with attendant anesthetic risks. An ideal bowel preparation regimen should clear the colon of fecal material with no alteration of the colonic mucosa that could affect the histological findings. There is no acceptable universal regimen for bowel preparation in children; however wide variability of practices exists globally. Hence, the current review is aimed at analyzing recent published literature and personal practical experiences as well as developing a standard bowel preparation guideline that will improve outcome of the ileo- colonoscopy procedure in children particularly in resource limited settings.