Sports drinks improve bowel preparation compliance and quality in autistic children: A randomized controlled trial

OBJECTIVE: To assess whether sports drinks as polyethylene glycol (PEG) solvent improve compliance, bowel preparation, and acceptability in children with autism spectrum disorder (ASD). METHODS: In this randomized trial, 60 ASD children (30 per group) received PEG in sports drinks (experimental) or water (control). Outcomes included compliance, Boston Bowel Preparation Scale (BBPS) scores, need for enemas, safety (glucose and electrolytes), adverse events, and caregiver-reported tolerance. RESULTS: The sports drink group had higher compliance (83.3% vs. 60.0%, relative risk [RR]:1.39, 95% confidence interval [CI]: 1.00-1.94, p = 0.045), reaching borderline statistical significance, as well as better BBPS (7.5 ± 0.8 vs. 6.0 ± 1.0, p < 0.05), and more adequate preparation (96.7% vs. 66.7%, RR: 1.45, 95% CI: 1.12-1.88, p = 0.003). They required fewer enemas (6.7% vs. 26.7%, RR: 0.25, 95% CI: 0.06-1.08, p = 0.038) and had fewer adverse events (10.0% vs. 33.3%, RR: 0.30, 95% CI: 0.09-0.98, p = 0.028). No concerning side effects were observed, and blood glucose and electrolyte levels remained within normal ranges. Caregiver tolerance scores were higher (median 8 vs. 6, p < 0.001). CONCLUSION: Sports drinks as PEG solvent significantly enhance compliance, bowel preparation, and acceptability in ASD children without safety concerns, offering a practical child-friendly strategy.