Medical clearance of the gut in children

Whether for chronic constipation or preparation before an investigation or surgery, medical clearance of the gut in children is challenging. In this article, Dr Morris Gordon summarises the current state of the evidence base. Recent evidence-based guidance and systematic reviews have improved the professional's ability to select the safest and most effective therapies. There is a reasonable evidence base to support the use of polyethylene glycol (PEG) and mineral oil to manage childhood constipation and some evidence that rectal enemas can support impaction. The evidence base for bowel preparation prior to colonoscopy is poor, but sodium phosphate, sodium picosulphate plus magnesium citrate and PEG appear effective, although PEG is poorly tolerated. Further research is needed in all areas.