With the popularization of digestive endoscopy in children, colonoscopy has been widely used. As the basis of digestive endoscopy, bowel preparation directly affects the diagnosis and treatment results of colonoscopy. Compared with adults, the functioning of important organs of children is immature, and their ability of cognition, communication and tolerance are weak. Their structure of the digestive tract is also significantly different in different ages. However, there have been no existing evidence-based guidelines on bowel preparation for digestive endoscopy of Chinese children. Therefore, it is important to develop evidence-based guidelines for bowel preparation combined with the clinical practice in China. In order to provide guidance and decision-making basis for Chinese pediatricians, we collaborated with multidisciplinary experts, based on existing evidence, adopted the grading of recommendations assessment, development and evaluation (GRADE) approach, followed the Reporting Items for Practice Guidelines in Healthcare (RIGHT) to develop this guideline for bowel preparation related to the diagnosis and treatment of children's digestive endoscopy.
Colonoscopy examination is the gold standard for diagnosis and treatment of colon diseases and screening for early cancer. Good quality of bowel preparation, which is also called intestinal cleanliness, is the prerequisite for full visualization of colonic mucosal lesions and their details. In clinic, more intestinal cleansing agents, such as polyethylene glycol and magneium suifate, have bad taste and high dosage, which can not be tolerated by some patients and affect the effect of bowel preparation. The use of oral adjuvant, add adjuvant to intestinal cleansing agents, new low-volume or very low-volume polyethylene glycol-ascorbic acid preparation methods, can reduce the incidence of adverse reactions, such as nausea and vomiting in patients, improve their tolerance, satisfaction and so on. This article reviews the methods of improving the taste and reducing the adverse reactions of intestinal cleansing agents at home and abroad to offer references for clinical practice.