Su2051 Combined Polyethylene Glycol and Sodium Picosulphate for Disimpaction in Children With Chronic Constipation and Palpable Faecaloma

Southwell, Bridget R.; Dughetti, L.; Jordan-Ely, Julie A.; Dobson, Kyla M.; Stathopolous, Lefteris; Leal, Marcelo C.; Catto‐Smith, Anthony G.; Hutson, John M.

doi:10.1016/s0016-5085(15)31980-6

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“…This study is a review of the abdominal X‐rays and diary records of the first week. Data on symptoms have been previously reported in abstracts . X‐rays were taken to determine fecal loading and the rectal:pelvic ratio before (day 1) and 1 week (day 8) after oral laxatives.…”

Section: Methodsmentioning

confidence: 99%

“…Data on symptoms have been previously reported in abstracts. 19,20 X-rays were taken to determine fecal loading and the rectal:pelvic ratio before (day 1) and 1 week (day 8) after oral laxatives. Inclusion criteria were: ≥2 years' chronic constipation defined by Rome III criteria 21 ; palpable fecaloma on presentation, confirmed by palpation by an experienced clinician; an enlarged stool-filled rectum on X-ray; and a rectal:pelvic ratio above the normal range (>0.61).…”

Section: Methodsmentioning

confidence: 99%

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Treatment of fecal impaction in children using combined polyethylene glycol and sodium picosulphate

et al. 2018

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Background and AimPolyethylene glycol (PEG) is the gold standard for fecal disimpaction in constipation. A regimen of PEG combined with the stimulant laxative sodium picosulphate (SPS) produced fecal disimpaction in chronically constipated children in the community, but it is unknown if it is effective for more severe constipation. To determine the stool output and effect of a combined PEG and SPS regimen on fecaloma in children with severe constipation and impaction.MethodsChildren with symptoms for a duration of ≥2 years, a palpable fecaloma, and enlarged rectum on X‐ray (rectal: pelvic ratio > 0.6) were recruited from a tertiary hospital. Daily diaries recorded laxative dose, stool frequency, volume, and consistency (Bristol stool scale, BSS). Abdominal X‐rays were taken on day 1 and day 8, and stool loading was assessed using the Leech score. Laxative doses were based on the child's age. The dose of PEG with electrolytes taken was 2–8 sachets (14.7 g/sachet) on days 1–2, reducing to 2–6 sachets on day 3. The SPS dose was 15–20 drops on days 2–3.ResultsEighty‐nine children (4–18 years) produced a large volume of soft stool (median/inter‐quartile‐range: 2.2/1.6–3.1 L) over 7 days. Stool volume on X‐rays decreased significantly in the colon (P < 0.001). Fecalomas resolved in 40 of 89 children, while 49 needed a second high dose. Rectal:pelvic ratios did not change.ConclusionsA combined high dose of PEG and SPS on days 1 and 2 was effective in removing the fecaloma in half of the children. Administering high doses for a longer period should be tested to provide outpatient disimpaction for severe fecalomas. Rectums remained flaccid after emptying.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%