Comparison of the effectiveness of polyethylene glycol 4000 without electrolytes and magnesium hydroxide in the treatment of chronic functional constipation in children

Abstract

Objective: To compare the effectiveness of two drugs, polyethylene glycol 4000 without electrolytes and magnesium hydroxide, in the treatment of chronic functional constipation in children.Methods: Thirty-eight children were randomly assigned to either of two groups, polyethylene glycol 4000 without electrolytes or magnesium hydroxide. The children were followed through periodic appointments until they reached 6 months of treatment. In each medical appointment the following aspects were evaluated: stool consistency, frequency of bowel movements, fecal incontinence, abdominal pain, straining and acceptance of the drugs.Results: Seventeen children made use of polyethylene glycol and twenty-one received magnesium hydroxide. All variables analyzed improved for both groups, with no statistically significant differences. All children accepted polyethylene glycol, while 42.9% refused magnesium hydroxide. Conclusion:The two laxatives showed no difference in effectiveness for the treatment of constipation. However, due to its better acceptance, because it is odorless and tasteless, polyethylene glycol proved to be a better option for treating chronic functional constipation.J Pediatr (Rio J). 2011;87(1):24-28: Treatment, children, constipation. ResumoObjetivo: Comparar a efetividade de dois medicamentos: hidróxido de magnésio e polietilenoglicol 4000 sem eletrólitos no tratamento da constipação intestinal crônica funcional em crianças. Métodos:Trinta e oito crianças foram divididas, por processo randô-mico, em dois grupos para uso de polietilenoglicol 4000 sem eletrólitos ou de hidróxido de magnésio. As crianças foram acompanhadas em consultas periódicas até completarem 6 meses de tratamento. Em todas as consultas, foram investigados: consistência das fezes, frequência evacuatória, presença de escape fecal, dor abdominal, esforço evacuatório e aceitação desses fármacos.Resultados: Dezessete crianças fizeram uso de polietilenoglicol, e 21 utilizaram o hidróxido de magnésio. Houve melhora clínica de todas as variáveis nos dois grupos, sem diferenças com significância estatís-tica. Todas as crianças aceitaram o polietilenoglicol, enquanto 42,9% recusaram o hidróxido de magnésio.Conclusão: Não houve diferença de efetividade no tratamento da constipação intestinal entre esses dois laxantes. Entretanto, a melhor aceitação do polietilenoglicol, por ser inodoro e insípido, torna-o melhor opção no tratamento da constipação intestinal crônica funcional.

A Comparative Trial: The Safety and Clinical Efficacy of PEG 3350 and Liquid Paraffin in Management of Chronic Functional Constipation in Children

“…In two studies, liquid paraffin efficacy was higher than Sena and lactulose [8,18]. Other studies were reported better PEG efficacy than lactulose and similar efficacy with Magnesium hydroxide [10,19]. Karami et al performed a comparative trial on PEG and liquid paraffin in chronic childhood functional constipation and stated their efficacies were remarkable that it was compatible with this study, but they administered higher dosages of medications and didn't evaluate the short-term outcome after drug discontinuation [14].…”

Modern Patient Management Procedure for Children With Constipation and Experience of Using the Osmotic Laxative for Its Treatment

“…[24] сравнивали эффективность ПЭГ и препа-рата магнезии, которую оценивали по частоте дефека-ций, наличию энкопреза, консистенции стула, натужива-нию при дефекации и переносимости лечения. 38 детей с запором были разделены на 2 группы случайным образом.…”

“…Сравнительные характеристики частоты, характера стула и переносимости лечения на 2, 4 и 6-м мес лечения приведены в табл. 4 [24].…”

“…Авторы исследо-ваний обращают внимание, что результаты анализа сле-дует интерпретировать с осторожностью из-за качества Таблица 4. Результаты лечения полиэтиленгликолем и магнезией [24] исследований и методологических проблем, клинической неоднородности и короткого интервала наблюдения. Тем не менее ПЭГ является безопасным и хорошо перено-симым препаратом.…”

Polyethylene Glycol

“…Studies were also performed to assess efficacy of PEG for fecal impaction and bowel preparation and for use in infants and younger children. Table 1 shows various pediatric studies comparing PEG or PEG þ E to other laxatives from different parts of the world during the last few years (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). All studies were prospective, although only a few were randomized controlled trials.…”