Risks of oral sodium phosphate for pre-colonoscopy bowel preparation in children

Excerpt

We appreciate the interest and concerns raised by Drs. Hassall and Lobe [1] in response to the recent intersociety guideline on bowel preparation for colonoscopy published in Gastrointestinal Endoscopy [2] as it pertains to the use of sodium phosphate (NaP) in children. As Drs. Hassall and Lobe are aware, the representatives of the three societies who convened (ASGE, SAGES, ASCRS) deal primarily with adults. In addition, recognizing the lack of expertise regarding pediatric issues, the three societies are indebted to Dr. Lobe for his authorship of the entire pediatric portion of the guideline [2]. In fact, this section was not intended to be a comprehensive review by the task force, the societies’ respective leadership, or Dr. Lobe. It was, however, meant to provide the “endoscopist dealing primarily with adults with a review of current practices in bowel preparation for the pediatric patient. We appreciate Drs. Hassall and Lobe bringing these new points to light in the pediatric arena, much like we did in a published addendum after the Food and Drug Administration (FDA) alert regarding the use of oral sodium phosphate products for bowel preparations [3]. However, one must keep in mind that it was not until May 2006 (when our original guideline was already in press) that CB Fleet advised against the use of Fleet Phospho-soda® in individuals younger than 18 years of age [4]. …