Comparison of Polyethylene Glycol Powder and Polyethylene Glycol 40% Syrup in Treatment of Chronic Idiopathic Constipation in Pediatrics (original) (raw)
Related papers
Polyethylene Glycol 4000 for Treatment of Functional Constipation in Children
Journal of Pediatric Gastroenterology & Nutrition, 2015
Objectives: The aim of the study was to evaluate the effectiveness and safety of 2 different polyethylene glycol (PEG) doses for the maintenance treatment of functional constipation in children. Methods: Children with functional constipation according to the Rome III criteria were randomly assigned to receive PEG 4000 at a dose of either 0.7 g/kg (high-dose group; n ¼ 45) or 0.3 g/kg (low-dose group; n ¼ 47) for 6 weeks. Adjustment of the therapy was recommended in the event of <3 bowel movements (BM) per week or !3 BM per day. The primary outcome measure was treatment success, defined as !3 BM per week with no fecal soiling during the last week of the intervention. Results: A total of 90 of 92 randomized children, with a mean age of 3.7 AE 2.1 years, completed the study. In the analysis based on allocated treatment, treatment success was similar in both groups (relative risk 0.9, 95% confidence interval 0.78-1.03). Compared with the high-dose PEG group, the low-dose PEG group had an increased need for therapy adjustment of borderline significance (relative risk 2.0, 95% confidence interval 1.0-4.2), an increased risk of painful defecation, a lower number of stools per week, and lower parental satisfaction. Adverse events were similar in both groups. Conclusions: To achieve treatment success, both tested doses of PEG were equally safe and effective in the treatment of children with functional constipation.
Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences, 2011
Functional constipation is prevalent in children. Recently polyethylene glycol has been introduced as an effective and safe drug to treat chronic constipation. There are only a few clinical trials on comparison of PEG and liquid paraffin in childhood constipation. The purpose of this study was to evaluate clinical efficacy and safety of PEG 3350 solution and liquid paraffin in the treatment of children with functional constipation in Sari Toba clinic during the period of 2008-2009. Children with a history of functional constipation were subjects of this study. One hundred and sixty children of 2-12 years old with functional constipation were randomized in two PEG and paraffin treatment groups. Patients received either 1.0-1.5 g/kg/day PEG 3350 or 1.0-1.5 ml/kg/day liquid paraffin for 4 months. Clinical efficacy was evaluated by stool and encopresis frequency/week and overall treatment success rate was compared in two groups. Compared with the baseline, defecation frequency/ week inc...
Archives of Disease in Childhood, 2007
Objectives: To assess the efficacy and safety of polyethylene glycol 3350 plus electrolytes (PEG+E) for the treatment of chronic constipation in children. Design: Randomised, double blind, placebo controlled crossover trial, with two 2-week treatment periods separated by a 2-week placebo washout. Setting: Six UK paediatric departments. Participants: 51 children (29 girls, 22 boys) aged 24 months to 11 years with chronic constipation (lasting >3 months), defined as (2 complete bowel movements per week and one of the following: pain on defaecation on 25% of days; >25% of bowel movements with straining; >25% of bowel movements with hard/lumpy stools. 47 children completed the double blind treatment. Main outcome measures: Number of complete defaecations per week (primary efficacy variable), total number of complete and incomplete defaecations per week, pain on defaecation, straining on defaecation, faecal incontinence, stool consistency, global assessment of treatment, adverse events and physical examination. Results: The mean number of complete defaecations per week was significantly higher for children on PEG+E than on placebo (3.12 (SD 2.05) v 1.45 (SD 1.20), respectively; p,0.001). Further significant differences in favour of PEG+E were observed for total number of defaecations per week (p = 0.003), pain on defaecation (p = 0.041), straining on defaecation (p,0.001), stool consistency (p,0.001) and percentage of hard stools (p = 0.001). Treatment related adverse events (all mild or moderate) occurred in similar numbers of children on PEG+E (41%) and placebo during treatment (45%). Conclusions: PEG+E is significantly more effective than placebo, and appears to be safe and well tolerated in the treatment of chronic constipation in children.
International Journal of Pediatrics, 2017
Background Constipation is one of the most common disorders in children. The purpose of this study was to compare paraffin and polyethylene glycol (PEG) in the treatment of children with chronic constipation. Materials and Methods This study is a double-blind randomized trial. Total 160 children aged 2-12 years old with chronic constipation attending the pediatric clinic of Mousavi Hospital in Zanjan (Iran) were examined by the same pediatric gastroenterologist. They randomly received PEG solution (1cc/kg/day divided in two doses) or paraffin at the same dose. Patients were assessed regularly once a week up to one month and then monthly until 6 months. Data were analyzed by SPSS version 16 software. Results From children enrolled in the study, 43.1% were boys with mean age 5.27±1.3 years. The male to female ratio in Paraffin and PEG groups was similar (35/45 vs. 34/46; respectively, P-value= 1.27). The mean age of the participants in paraffin group and PEG group were 5.28±1.4 and 5....
Journal of Research in Medical Sciences, 2012
BACKGROUND: Constipation is one of the common problems in childhood and consists of 3% of referrals to pediatricians and 25% of pediatric gastroenterologists. Aperients are common alternatives for treating chronic constipation. The present study aimed to compare the efficacy of three laxatives [polyethylene glycol (PEG), magnesium hydroxide, and lactulose]. METHODS: In this randomized clinical trial, 1 to 6 year old children with functional chronic constipation (the patients had functional chronic constipation based on ROME III criteria) were studied. 75 patients were divided into three 25 member groups through randomization method. The patients of each group received either of the polyethylene glycol, magnesium hydroxide, or lactulose medications in a standard dosage. After a month, the results were assessed and analyzed through statistical tests. RESULTS: Comparing the frequency of increased defecation in patients of the three groups also found no significant difference among them; however, mean increase of defecation frequency was higher in the magnesium hydroxide group. Compared to patients who had more than three times of defecation per week, PEG group was significantly higher than the other two groups (p < 0.05). Comparing the side effects showed that the prevalence of side effects was lower in the polyethylene glycol group than the other two groups. The patients had a significantly higher satisfaction from the taste of polyethylene glycol and lactulose (p < 0.01). CONCLUSIONS: Although the total mean of increase in defecation frequency after the treatment was higher in the magnesium hydroxide group, the indicator of defecation frequency greater than three times per week was higher in the polyethylene glycol group which indicated the success of treatment in this group. In total, comparing the therapeutic results and satisfaction of the patients, it can be concluded that polyethylene glycol can be used as one of the best alternatives to treat constipation.
International Journal of Basic & Clinical Pharmacology
Background: Functional constipation (FC) is a common pediatric problem worldwide. The management of FC comprises of a short initial disimpaction phase followed by long-term maintenance phase. Currently, polyethylene glycol (PEG) is considered as standard disimpaction therapy in pediatric FC patients. The aim of our study was to compare the efficacy of polyethylene glycol 3350 monotherapy with polyethylene glycol 3350 and sodium picosulfate combined therapy in treating fecal impaction in pediatric FC patients. Methods: All children (aged >1 year) diagnosed with FC as per ROME IV criteria and presenting to the out-patient department of pediatric gastroenterology, hepatology and nutrition unit of a tertiary health centre in north Indian Himalayan state were randomized into two open label, prospective, parallel groups, namely group A (receiving PEG 3350 monotherapy) and group B (receiving combined PEG 3350 plus sodium picosulfate therapy), over a period of 13 months. The outcome was ...
Iranian Journal of Pediatrics
Background: Functional constipation (FC) is a common major problem in children. This study compared Jujube paste and polyethylene glycol (PEG) as laxative drugs in children with FC. Ziziphus Jujuba Mill (Jujube) was selected according to traditional Iranian medicine because it is native to Iran and a large extent of Asia, is safe and easy to access, with acceptable taste to children. Methods: This randomized controlled clinical trial was performed on 128 children aged 2 to 12 with FC according to Rome IV criteria. Patients were randomly divided into two groups of Jujube paste and PEG and underwent four weeks of treatment. The efficacy, safety, and tolerability of the Jujube oral product were compared with PEG. Results: Following four weeks of therapy, all clinical symptoms of constipation according to Rome IV criteria were improved significantly in both groups (P < 0.05). In all the seven criteria of Rome IV, Jujube paste was as effective as PEG and even stronger in reducing stoo...
Journal of Paediatrics and Child Health, 2018
Aim: To find the aetiological spectrum, clinical features to differentiate organic from functional constipation (FC) and the efficacy of polyethylene glycol (PEG) over lactulose in the treatment of childhood constipation. Methods: From January 2007 to December 2014, 316 consecutive children (up to 18 years) with constipation were included in this study. FC was defined as per Rome III criteria. Standard treatment protocol (disimpaction with PEG followed by laxatives) was followed in FC. Lactulose was used in the first 4 years of study and PEG in the last 4 years. Success of therapy was assessed at 3 months. Results: The median age was 44 (25.00-78.00) months, and 227 (72%) were boys. The majority, 245 (77.5%), had FC, while Hirschsprung disease was the most common organic cause (39.4%). On multivariate analysis, delayed passage of meconium, growth failure, absence of retentive posturing and absent faecal impaction significantly (P < 0.05) determined an organic aetiology. In FC, successful outcome at 3 months was achieved equally with PEG and lactulose (81 vs. 76%, respectively). However, more children in lactulose group had to be switched over to PEG due to lack of efficacy (P = 0.0002). Conclusions: FC is the most common cause of constipation in children. Presence of delayed passage of meconium, growth failure and absence of retentive posturing and absent faecal impaction raise the suspicion of an organic cause. Both lactulose and PEG are equally effective. PEG has an edge over lactulose as the need for switch over was uncommon.
Use of polyethylene glycol in functional constipation and fecal impaction
Revista Española de Enfermedades Digestivas, 2016
Objective: The objective of this study was to evaluate in an analytical and descriptive manner the evidence published so far on the use of polyethylene glycol (PEG), with or without electrolytes, in the management of functional constipation and the treatment of fecal impaction. Methodology: Search on MEDLINE, EMBASE and Cochrane databases until May 2016 of all publications adjusted to the following terms: constipation AND/OR fecal impaction AND (PEG OR polyethylene glycol OR macrogol OR movicol OR idralax OR miralax OR transipeg OR forlax OR golytely OR isocolan OR mulytely) NOT colonoscopy. Critical reading of selected articles (English or Spanish), sorting their description according to group age (adult/pediatric age) and within those, in accordance with study features (efficacy evaluation versus placebo, doses query, safety, comparison with other laxatives, observational studies and monographic review articles of polyethylene glycol or meta-analysis). Results: Fifty-eight publications have been chosen for descriptive analysis; of them, 41 are clinical trials, eight are observational studies and nine are systematic reviews or meta-analysis. Twelve clinical trials evaluate PEG efficacy versus placebo, eight versus lactulose, six are dose studies, five compare polyethylene glycol with and without electrolytes, two compare its efficacy with respect to milk of magnesia, and the rest of the trials evaluate polyethylene glycol with enemas (two), psyllium (one), tegaserod (one), prucalopride (one), paraffin oil (one), fiber combinations (one) and Descurainia sophia (one). Conclusions: Polyethylene glycol with or without electrolytes is more efficacious than placebo for the treatment of functional constipation, either in adults or in pediatric patients, with great safety and tolerability. These preparations constitute the most efficacious osmotic laxatives (more than lactulose) and are the first-line treatment for functional constipation in the short and long-term. They are as efficacious as enemas in fecal impaction, avoid the need for hospital admission and are well tolerated by patients (mainly when administered without electrolytes).