The most commonly used methods for bowel preparation are polyethylene glycol-electrolyte lavage solution (PEG-ELS) and sodium phosphate. Both are problematic in children. The use of bisacodyl together with fleet enema has been suggested as an alternative; however, its use without dietary restriction is inferior to other preparations. We aimed to study the effect of bisacodyl together with fleet enema and a half day of clear fluid diet.
Ninety-eight children (aged 30 months to 12 years) were studied prospectively according to the following protocol: on the day prior to the colonoscopy, the patient received a 5-mg bisacodyl tablet at noon and started a clear fluid diet. An additional bisacodyl tablet was taken in the evening by patients more than 5 years old. Two pediatric fleet enemas were performed, on the evening before and on the morning of the procedure. The patients were compared with 26 historical control patients that had been prepared with PEG-ELS solution.
The compliance of the bisacodyl group was excellent (100%), compared with 88% of the control group. Ninety-five percent of the bisacodyl group had good to excellent bowel preparation, compared with 88% of the PEG-ELS group.
This method is safe and appropriate for use in children younger than 12 years.