***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Colorectal surgeries frequently require bowel preparation . In children , ( is this st and ard of care ? : this method is mostly followed ) this is usually performed using normal saline , which is very cumbersome and causes unnecessary discomfort . This study compared polyethylene glycol ( PEG ) with normal saline for preoperative bowel preparation in children . Patients and Methods : Thirty patients , admitted in the Department of Paediatric Surgery , Rajindra Hospital , Patiala , for colonic and colorectal surgical procedures , were divided into two groups , I ( PEG ) and II ( NS ) , r and omly for bowel preparation with PEG and normal saline , respectively . Results : It was found that there was no significant difference in the quality of preparation ( P > 0.05 ) , but PEG use was found to be easier , more comfortable and acceptable for the patients , their relatives and the hospital staff . Overall , complications are significantly lesser for PEG preparation ( P < 0.05 ) . There was no significant difference in the overall cost . Conclusion : Thus , it can be inferred that PEG may be a safe , cost-effective and acceptable option for large bowel preparation Flexible fiberoptic colonoscopy is an established diagnostic procedure in the pediatric patient . The approach to the pediatric patient is , however , different from the approach to adults . Bowel preparation must be geared to the age , size , and clinical status of the patient . An effective , palatable , st and ardized bowel preparation has not been determined for the child undergoing a colonoscopy . This study systematic ally evaluated three components of the bowel preparation -- cathartics , diet , and enema use . The bowel preparation of 140 children undergoing colonoscopy at The Children 's Hospital of Philadelphia was evaluated . The effectiveness of the bowel preparation was evaluated by direct visualization during the colonoscopy as to the amount and consistency of the residual stool in the colon . Parents were interviewed to determine adherence to the instructions including tolerance of diet , cathartics , and enema administration . Equipment maintenance was also monitored . An effective bowel preparation was achieved in all groups . As a result of this study , the Division of Gastroenterology and Nutrition at The Children 's Hospital of Philadelphia now uses a less restrictive diet , one enema , and X-Prep to achieve effective bowel preparation for colonoscopy Objective : Many protocol s of bowel preparation are available for use in children ; however , none of them is commonly accepted . The aim of the study was to evaluate the efficacy and acceptability of high-volume polyethylene glycol ( PEG ) versus low-volume PEG combined with bisacodyl ( BPEG ) versus sennosides for colonoscopy preparation in children . Methods : Participants ages 10 to 18 years were r and omly assigned to receive either PEG 60 or PEG 30 mL kg−1 day−1 plus oral bisacodyl 10 to 15 mg/day or sennosides 2 mg kg−1 day−1 for 2 days . A blinded assessment of bowel cleansing was made by the endoscopist according to the Aronchick and Ottawa scales . Patient acceptability was evaluated with the visual-analog scale . Analysis was done on an available case analysis basis . Results : Of 240 patients enrolled in the study 234 patients were available for analysis of the efficacy of colon cleansing . There were no significant differences found among the 3 groups for the proportions of participants with excellent/good ( PEG : 35/79 , BPEG : 26/79 , sennosides 25/76 ) and poor/inadequate ( PEG : 20/79 , BPEG : 28/79 , sennosides 28/76 ) bowel preparation evaluated with the Aronchick scale and for the mean Ottawa total score ( PEG : 5.47 ± 3.63 , BPEG : 6.22 ± 3.3 , sennosides : 6.18 ± 3.53 ) . Acceptability of bowel cleansing protocol was similar in all of the groups ( P = 0.8 ) . Conclusions : All 3 cleansing methods showed similar efficacy and tolerability ; however , none of them was satisfactory BACKGROUND AND STUDY AIMS Comparison of bowel preparation for colonoscopy in children with either Pico-Salax ( sodium picosulphate with magnesium citrate ) or polyethylene glycol with electrolyte solution ( PEG-ELS ) .  PATIENTS AND METHODS In this investigator-blinded , r and omized controlled trial , 83 children ( 12.5 + /- 3.1 years ) requiring elective colonoscopy at a referral hospital were r and omly allocated to Pico-Salax ( n = 43 ) or PEG-ELS ( n = 40 ) , and an intention-to treat analysis was applied . Pico-Salax was administered in two doses , one the evening before and one on the morning of the procedure . PEG-ELS was administered over 4 hours . Efficacy was scored using the Ottawa scale and other constructs . Tolerability and toxicity were measured by patient and nursing question naires and serum biochemistry . RESULTS 35 of Pico-Salax patients ( 81 % ) were satisfied or very satisfied with the cleanout , compared with 19 ( 48 % ) in the PEG-ELS group ( P = 0.001 ) . No differences were found in bowel cleanout effectiveness , as judged by the Ottawa score ( P = 0.24 ) , completion rates ( P = 0.69 ) , colonoscopy duration ( P = 0.59 ) , need for enemas ( P = 0.25 ) , or physician 's global impression ( P = 0.7 ) . Except for one case of mild dehydration in the Pico-Salax group , no clinical ly significant adverse events were recorded . Serum biochemistry results were similar between groups except for more hypermagnesemia associated with Pico-Salax and hypokalemia with PEG-ELS ; neither was clinical ly significant . CONCLUSION Children tolerate Pico-Salax better than PEG-ELS for bowel cleanout before colonoscopy . This study did not demonstrate superiority of effectiveness or safety for either regimen The role of preoperative bowel prep in the pediatric surgical population is uncertain . We performed a r and omized prospect i ve study to evaluate noninferiority between the presence or absence of a preoperative bowel prep in  elective pediatric bowel surgery  on postoperative outcomes . Patients aged three months to 18 years were recruited and r and omized to the bowel prep group or the no bowel prep group . Patients were evaluated in-hospital and at postoperative clinic visits . Thirty-two patients were recruited ; 18 in the bowel prep group and 14 in the no bowel prep group . There was no statistical difference ( P > 0.05 ) in complications between the groups . Complications were observed in five patients in each group ( 27.8 % and 35.7 % , respectively ) . In the bowel prep group , two ( 11.1 % ) had wound infection ( vs three , 21.4 % ) , 0 had an intra-abdominal abscess ( vs one , 7.1 % ) , one ( 5.6 % ) had sepsis ( vs one , 7.1 % ) , one ( 5.6 % ) had an anastomotic leak ( vs 0 ) , and three ( 16.7 % ) had a bowel obstruction ( vs one , 7.1 % ) . There were no extra-abdominal complications . There were no significant differences in complications between the two groups . Further research is warranted , but may require a multi-institutional trial to recruit sufficient numbers to make conclusions about the significance of the need for bowel prep AIMS To undertake a prospect i ve , single blind , r and omised trial comparing the efficacy and tolerance of two outpatient colonoscopy bowel preparation regimens . METHODS Patients aged between 18 months and 16 years being admitted for day case colonoscopy were allocated r and omly to receive either Picolax ( an oral , sugar free powder containing sodium picosulphate 10 mg/sachet with magnesium citrate ) and clear fluids or bisacodyl tablets with an unrestricted diet and a phosphate enema just before colonoscopy .  Patient compliance , bowel frequency , and associated symptoms were recorded , and the adequacy of the bowel preparation was assessed in a blinded manner . RESULTS 63 of 66 patients completed the trial . Mean age , mean weight , extent of colonoscopy , and distribution of underlying pathology were similar in both groups .  Bowel preparation was good or excellent in all of the patients in the Picolax group ( n = 32 ) compared with 22 patients in the bisacodyl/phosphate enema group ( n = 31 ) . The latter group experienced more abdominal discomfort during bowel preparation but three of the Picolax group vomited and the lack of solid food distressed some children . CONCLUSIONS All bowel preparation methods have limitations and unpleasant side effects but the use of Picolax and clear fluids proved superior to bisacodyl tablets and a phosphate enema in children undergoing day case colonoscopy Background Polyethylene Glycol 3350 ( Miralax ® ) without electrolytes is commonly used for 3–4 days as bowel preparation for colonoscopy in children .  One-day preparation has been anecdotally reported to be effective but there are few published prospect i ve studies comparing the safety and efficacy of one-day preparation with that of three-day preparation . This study was conducted to compare the efficacy and safety of a one-day bowel preparation with Miralax ® with that of a three-day preparation for colonoscopy in children . Methods We conducted a prospect i ve , r and omized controlled trial with children age 2–21 yrs . undergoing elective colonoscopy . Patients were r and omly assigned to receive Miralax ® for either one or three days . Children with known electrolyte disturbances , dehydration , fecal impaction , metabolic or renal disease were excluded . A metabolic panel was monitored before and after bowel preparation . Subjects reported the tolerability and side effects of Miralax ® via a survey . Effectiveness of the bowel preparation was assessed using a stool diary and a bowel cleansing scale during colonoscopy . Results 32 subjects were enrolled ; 18 received one-day bowel preparation and 14 received 3-day preparation . There were no differences between the groups in efficacy of bowel preparation based on colonoscopic grading or the safety of the preparation . One-day preparation was as well tolerated as three-day preparation . Conclusion Miralax ® used one day as bowel preparation for elective colonoscopy in children is safe , effective and well tolerated . Physicians should consider offering a one-day option for bowel preparation , which would allow children to miss fewer days of school prior to colonoscopy . Trial registration Trial Registration Number : http:// clinical trials.gov/ct2/show/NCT02174497?term=NCT02174497&rank=1 . Date of Registration : 02 May , 2014 URL of register : clinical trials.gov BACKGROUND / PURPOSE The current health care environment pressures providers to lower cost and dem and s quality care that is measured by outcomes and patient satisfaction . Most insurers will not approve bed days for in-hospital preoperative bowel preparations for elective colorectal procedures . This policy does not take into account that infants and children are unable to tolerate large volumes of enteral preparation , which adversely affects outcome because of an inadequate preparation . This report describes a prospect i ve evaluation of a st and ard home bowel preparation regimen utilizing local and regional home health care agency support . METHODS For an elective colorectal procedure , pediatric patients underwent a home bowel preparation using GoLYTELY ( 100 mL/kg ) via a nasogastric tube infused over 4 hours by a pediatric home health nurse trained in this technique . During the bowel preparation , the nurse educated the family members about the service and performed physiological monitoring to insure safety . At the completion of the preparation , any unusual events were transmitted to the staff surgeon for further instructions . Our initial 30 patients were treated by our hospital home health agency personnel to insure safety . Since then , 41 additional bowel preparations have been performed by statewide agencies . RESULTS Seventy-one patients underwent complete home bowel preparation ( 45 boys ; 26 girls ) . The age range was 3 months to 9 years ( average , 5 months ) . There was one complication caused by incorrect mixing of GoLYTELY causing gastrointestinal cramping . All 71 home bowel preparations were recorded as good at the time of the colorectal procedure by the staff pediatric surgeon . The average cost for home bowel preparation  was $ 300 in network , and $ 350 out of network . This compares with an inpatient hospital day cost of greater than $ 800 ( $ 36,000 savings ) . CONCLUSIONS This technique offers the pediatric surgeon an opportunity to maintain a high st and ard of quality care while using home health agency personnel to minimize cost . This program is safe , effective , and associated with a good outcome and a high degree of family satisfaction OBJECTIVE : We performed a prospect i ve , r and omized , single-blind study in children undergoing colonoscopy to evaluate the acceptance and efficacy of three different bowel preparations . METHODS : Seventy patients ( ages 3–20 yr , 38 males ) were r and omly assigned to one of the three study preparations : Magnesium citrate with X-prep and clear liquid diet for 2 days ( group A ) ; Dulcolax for 2 days and Fleet enema without dietary restriction ( group B ) ; and Golytely 20 m 
    Output:
    
There is evidence that all regimens are equally effective .
However , sodium picosulfate was better tolerated than PEG .