Pediatr Gastroenterol Hepatol Nutr.  2017 Dec;20(4):244-251. 10.5223/pghn.2017.20.4.244.

Efficacy and Safety of Combined Oral and Enema Therapy Using Polyethylene Glycol 3350-Electrolyte for Disimpaction in Pediatric Constipation

• Yoo T
• Bae SH

• KMID: 2398906
• DOI: http://doi.org/10.5223/pghn.2017.20.4.244

Abstract

PURPOSE
We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children.
METHODS
We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d), and an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients.
RESULTS
Administration of oral and enema doses of PEG 3350 electrolyte solution showed 2.1±0.3 times and 2.9±0.4 times, respectively. After disimpaction, the frequency of defecation increased from 2.2±0.3 per week to once a day (1.1±0.1 per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted.
CONCLUSION
In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.

Keyword

Constipation; Child; Therapeutics; Polyethylene glycols

MeSH Terms

Abdominal Pain
Child
Child, Hospitalized
Colon
Constipation*
Defecation
Electrolytes
Enema*
Hospitalization
Humans
Inpatients
Osmolar Concentration
Outpatients
Polyethylene Glycols*
Polyethylene*
Retrospective Studies
Electrolytes
Polyethylene
Polyethylene Glycols

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