Ian Glenn gives a review of the literature to answer the question of whether or not we need bowel prep in children.
Type: video · 1 min · posted 2019-04-11 Canonical: https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331 ## Chapters - [0:03](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=3) Clinical Question: Bowel Prep for Colostomy Takedown - [0:34](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=34) Literature Review: Adult and Pediatric Evidence - [1:07](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=67) Clinical Decision ## Statements - "Adult prospective randomized trials show mechanical bowel prep alone does no good or probably harms patients" — Ian Glenn (clinical) [0:35](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=35) - "Oral antibiotics that are not absorbed are probably beneficial in adult colorectal surgery" — Ian Glenn (clinical) [0:41](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=41) - "One pediatric study showed mechanical bowel prep by itself led to higher infection rates in children" — Ian Glenn (clinical) [0:51](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=51) - "One pediatric study showed mechanical bowel prep by itself led to longer hospital stays in children" — Ian Glenn (clinical) [0:51](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=51) - "In one pediatric study, addition of antibiotics to mechanical bowel prep did not make any difference in outcomes" — Ian Glenn (clinical) [0:51](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=51) - "Another pediatric study showed mechanical bowel prep with oral antibiotics made no difference compared to no prep" — Ian Glenn (clinical) [1:01](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=61) - "For pediatric colostomy takedown, it is reasonable to omit both mechanical bowel prep and oral antibiotics" — Ian Glenn (opinion) [1:07](https://library.globalcastmd.com/watch/do-we-need-bowel-prep-1331?t=67) ## Transcript So today I have a patient that I'm scheduling for surgery. She has a colostomy. I'm doing a colostomy takedown, and I wanted to know what is the new. What is the new standard of care for colostomy takedowns and bowel preps? What does the literature say in this day and age about how we should be managing these patients? So, I asked my fellow, Ian Glenn, who is a, my research fellow, he's a general surgery resident at the Cleveland Clinic, and he's doing research here at Akron Children's. What's the data say about this? That's a good question, Todd. You know, if you look at the adult literature, there's pretty good prospective randomized trials that show that. Mechanical bowel prep alone in adults is doing them no good or probably harming them, and oral antibiotics that aren't absorbed are probably a good idea. In kids, there are two good studies. One study showed that mechanical bowel prep by itself led to a higher rate of infection and longer hospital stays in kids, and addition of antibiotics didn't make any difference. And then there was another study that showed that mechanical bowel prep and oral antibiotics didn't make a difference at all between the two groups. So, I think for your patient, it probably makes sense to not do either one. Nothing. Correct. No mechanical, no oral antibiotics. Yep, exactly. All right, there you go. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai