NEW HORIZON FOR TREATMENT IN...
Bowel preparation for pediatric colonoscopy: A national Sigenp survey
Elvira Difrancisca, Antonio Corsello, Martina Genduso, Luca Maria Antoniello, Mara Cananzi, Sara Renzo, Paola De Angelis, Francesca Cavataio, Claudio Romano
U.O. Pediatria ad indirizzo gastroenterologico, Ospedale dei Bambini “G. Di Cristina”, ARNAS Civico-Di CristinaBenfratelli, Via dei Benedettini 1, 90134 Palermo (PA), Italia.
Inadequate bowel preparation remains one of the main determinants of suboptimal pediatric colonoscopy, because it reduces mucosal visibility, prolongs procedure time, increases the need for repeat exams, and may compromise diagnostic yield and patient safety. Although adult-derived protocols have long influenced practice, pediatric bowel preparation must account for age, tolerance, comorbidities, family support, and the practical burden of large-volume solutions. In this article, we summarize the current evidence on bowel preparation agents and strategies in children, with particular attention to low-volume regimens based on polyethylene glycol or sodium picosulfate, split-dose approaches, and the role of diet and educational support. We also discuss the results of a national survey showing marked heterogeneity across Italian centers and incomplete adherence to European recommendations. The most relevant innovation is not a new drug class, but a shift toward individualized yet standardized pathways that combine evidence-based regimens, better palatability, and validated cleansing scores. A more uniform approach may improve colonoscopy quality, reduce repeat procedures, and enhance the child’s and family’s experience.