Pediatric Gastroenterology, Hepatology & Nutrition

  • 제24권2호
  • /
  • Pages.230-237
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  • 2021
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  • 2234-8646(pISSN)
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  • 2234-8840(eISSN)
대한소아소화기영양학회 (The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition)
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Polyethylene Glycol Plus Electrolytes with Stimulant Laxative in Paediatric Faecal Disimpaction: A Randomised Controlled Study

  • 투고 : 2020.05.26
  • 심사 : 2020.10.02
  • 발행 : 2021.03.15
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초록

Functional constipation is common in the paediatric population all over the world. Effective disimpaction to evacuate the impacted faecal matter forms an essential initial step in the management of constipation. Though different regimens of polyethylene glycol 3350 with electrolytes (PEG+E) are accepted as the prime medication for disimpaction, response is not always satisfactory. A randomised prospective study was undertaken, in a tertiary paediatric Gastroenterology centre to find out the outcome of a 2-day disimpaction when a stimulant laxative sodium picosulphate was added to PEG3350+E (PEG+E+PS group) and comparing it with the outcome using PEG3350+E (PEG+E group) alone. Hundred and one children were randomised into two groups to receive PEG+E+PS and PEG+E. Results revealed that PEG+E+PS group proved significantly superior to PEG+E group in most of the efficacy-parameters in terms of disimpaction as well as long-term management of constipation. Though stimulant laxatives are being used for disimpaction, comparative data are lacking. This was the 1st such comparative study looking at the efficacy of these two processes of disimpaction along with long term effect on treatment.

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참고문헌

  1. Khanna V, Poddar U, Yachha SK. Etiology and clinical spectrum of constipation in Indian children. Indian Pediatr 2010;47:1025-30. https://doi.org/10.1007/s13312-010-0175-2
  2. Rajindrajith S, Devanarayana NM, Adhikari C, Pannala W, Benninga MA. Constipation in children: an epidemiological study in Sri Lanka using Rome III criteria. Arch Dis Child 2012;97:43-5. https://doi.org/10.1136/adc.2009.173716
  3. National Institute for Health and Care Excellence. Constipation in children and young people: diagnosis and management [Internet]. London: National Institute for Health and Care Excellence; 2010 May 26 [cited 2020 May 15]. Available from: https://www.nice.org.uk/guidance/cg99/chapter/Patient-centred-care
  4. Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr 2014;58:258-74. https://doi.org/10.1097/MPG.0000000000000266
  5. Jordan-Ely J, Hutson JM, Southwell BR. Disimpaction of children with severe constipation in 3-4 days in a suburban clinic using polyethylene glycol with electrolytes and sodium picosulphate. J Paediatr Child Health 2015;51:1195-8. https://doi.org/10.1111/jpc.12939
  6. Guest JF, Candy DC, Clegg JP, Edwards D, Helter MT, Dale AK, et al. Clinical and economic impact of using macrogol 3350 plus electrolytes in an outpatient setting compared to enemas and suppositories and manual evacuation to treat paediatric faecal impaction based on actual clinical practice in England and Wales. Curr Med Res Opin 2007;23:2213-25. https://doi.org/10.1185/030079907X210462
  7. Candy DC, Edwards D, Geraint M. Treatment of faecal impaction with polyethelene glycol plus electrolytes (PGE + E) followed by a double-blind comparison of PEG + E versus lactulose as maintenance therapy. J Pediatr Gastroenterol Nutr 2006;43:65-70. https://doi.org/10.1097/01.mpg.0000228097.58960.e6
  8. Tolia V, Lin CH, Elitsur Y. A prospective randomized study with mineral oil and oral lavage solution for treatment of faecal impaction in children. Aliment Pharmacol Ther 1993;7:523-9. https://doi.org/10.1111/j.1365-2036.1993.tb00128.x
  9. Philichi L, Yuwono M. A retrospective study comparing polyethylene glycol-electrolyte solution with magnesium citrate for treatment of fecal disimpaction. Gastroenterol Nurs 2018;41:141-4. https://doi.org/10.1097/SGA.0000000000000315
  10. Youssef NN, Peters JM, Henderson W, Shultz-Peters S, Lockhart DK, Di Lorenzo C. Dose response of PEG 3350 for the treatment of childhood fecal impaction. J Pediatr 2002;141:410-4. https://doi.org/10.1067/mpd.2002.126603
  11. Paediatric Formulary Committee. BNF for Children (BNFC) 2016-2017. London: Pharmaceutical Press, 2016:35.
  12. Ingebo KB, Heyman MB. Polyethylene glycol-electrolyte solution for intestinal clearance in children with refractory encopresis. A safe and effective therapeutic program. Am J Dis Child 1988;142:340-2. https://doi.org/10.1001/archpedi.1988.02150030114035