Colonoscopy Preparation Clinical Trial
Official title:
High-volume Polyethylene Glycol Solution (PEG) Versus Low-volume PEG Plus Stimulant Laxative Versus Sennosides for Colon Cleansing Before Colonoscopy: a Randomized, Single Blinded Study
Background:
Polyethylene glycol (PEG) solution has been proven to be effective for large bowel cleansing
prior to colonoscopy in children. However, the high volume of fluid and its taste sometimes
lead to inappropriate cleansing of the bowel, thus search for other bowel preparation is
needed.
Aim:
The efficacy and tolerability of three different bowel cleansing protocols used in children
for colonoscopy: high-volume PEG compared with low-volume PEG with stimulant laxative
(bisacodyl) compared with sennosides.
Methods:
Participants aged 10-18 years will be randomly assigned to receive either PEG 60 ml/kg/day
or PEG 30 ml/kg/day plus oral bisacodyl 10-15 mg/day or sennosides 2mg/kg/day for 2 days
prior to the colonoscopy. The outcome measures will be:bowel cleansing efficacy, scored by a
blinded endoscopist using the Ottawa scale and Aronchick Scale (the mean total score,
proportions of participants with excellent/good and with poor/inadequate bowel preparation),
and the patient satisfaction score(0-10)with the method of preparation for the colonoscopy
evaluated with the visual analog scale. Analysis will be done on an intention to treat
basis.
Patients are excluded if they had known allergy to one of the tested preparations such as
bisacodyl (Bisacodyl VP, ICN Polfa, Rzeszow, Poland), polyethylene glycol (Fortrans,
Beaufour Ipsen Industry, Dreux, France) and/or sennoside (Xenna Extra, US Pharmacia,
Wroclaw, Poland) and had disorders that make oral intake of the preparation impossible
(neurological disorders, intestinal obstruction, mental retardation etc.).
Study design:
On admission day patients are allocated to one of the groups by study investigators,
according to the randomization list created by an independent person using block
randomization by a standard statistical program StatsDirect [version 2,3,8 (2005)] (6
patients were included in each block).
During the preparation for colonoscopy each patient are observed for procedure tolerance. On
the day of endoscopy, each patient evaluated the degree of the acceptance of the method of
bowel cleaning (according to visual analog scale (VAS) and the occurrence of side effects
(diary). The endoscopist performing colonoscopy, blinded for the bowel preparation regimen
evaluate bowel cleansing and score it, according to the Aronchick and Ottawa scale. The rate
of cecum intubation, and the colonoscopy complications (defined as bowel perforation and/or
significant bleeding) are analyzed in each bowel preparation group.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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