Polyethylene glycol 3350 plus electrolytes for chronic constipation in children: a double blind, placebo controlled, crossover study

• Published in: Archives of disease in childhood Vol. 92; no. 11; pp. 996 - 1000
• Main Authors: Thomson, M A, Jenkins, H R, Bisset, W M, Heuschkel, R, Kalra, D S, Green, M R, Wilson, D C, Geraint, M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.11.2007; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; BMJ Group
• Subjects: Biological and medical sciences; Care and treatment; Cathartics - therapeutic use; Child; Child, Preschool; Children; Children & youth; Chronic Disease; Constipation; Constipation - drug therapy; Cross-Over Studies; Demographic aspects; Dosage and administration; Double-Blind Method; Double-blind studies; Electrolytes; Electrolytes - therapeutic use; Eligibility; Ethics; Evaluation; Experimental design; Fecal incontinence; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; Laxatives; Male; Medical Evaluation; Medical sciences; Miscellaneous; Original; Other diseases. Semiology; Pain; Pediatrics; Physical Examinations; Physiological aspects; Placebos; Polyethylene; Polyethylene glycol; Polyethylene Glycols - therapeutic use; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Scientific Concepts; Statistical Analysis; Stimulants; Stimuli; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Treatment Outcome; Water; United Kingdom; United Kingdom > UK; Human; Pediatrics; Drug combination; Ethylene oxide polymer; Chronic; Electrolyte; Placebo; Double blind study; Digestive diseases; Intestinal disease; Constipation; Child; Public health
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.2006.115493

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.