Clinical value of Bristol stool form scale for bowel preparation in pediatric patients undergoing colonoscopy

Objective To evaluate the clinical value of Bristol stool form scale(BSFS) for bowel preparation in pediatric patients. Methods Data of 202 pediatric patients undergoing colonoscopy were collected from May 2016 to December 2016 at Children′s Hospital of Fudan University. All patients received polyethylene glycol (PEG)-4000 with clear fluid diet for bowel preparation. BSFS was used to record the stool form, and Boston bowel preparation scale (BBPS) was used to evaluate the quality of bowel cleansing. Differences in BBPS score between the enema group with BSFS 6 and the no enema group with BSFS 7 were studied. Based on the data types, t(or t′) test and chi-square test were used to analyze the influencing factors for colon preparation respectively. Those factors of statistical significance were studied with multivariate logistic regression analysis. Results The mean defecation time of pediatric patients during bowel preparation was 14.4±6.8. One hundred and sixty-five (81.7%) patients were assessed as 7 points in BSFS, 37 (18.3%) were 6 points in BSFS with supplemented enema, and 154(76.2%) patients achieved adequate bowel preparation. No significant differences were observed between the no enema group and enema group in the BBPS scores [75.2%(124/165) VS 81.1%(30/37), χ2=0.587, P=0.526]. Significant factors for inadequate colon preparation were constipation history(χ2=32.588, P=0.000), total time of defecation(t=3.432, P=0.001) and total time of BSFS 7 (t′=2.877, P=0.005). Multivariate logistic regression analysis showed constipation history(P=0.000, OR=12.620, 95%CI: 4.850-32.800) was independent risk factor for inadequate colon preparation. Conclusion Patients of BSFS 6 points could receive warm saline enema as a remedy. Patients with total time of defecation less than 15 and total time of BSFS (7 points) less than 8 are liable for the possibility of inadequate bowel preparation. It is also suggested that for patients with constipation history, the time of bowel preparation should be prolonged for microscopic visual field clarity. Key words: Child; Colonoscopy; Bowel preparation