Constipation in children accounts f...

Constipation in children accounts for approximately 3 percent of outpatient visits to general clinics for children by means of year. Treatment can include dietary and behavior modifications, counseling, and the use of various laxatives and stool softener Polyethylene glycol 3350 (PEG) is an osmotic laxative that popularly is being used to cleanse the gastrointestinal tract before diagnostic or surgical practices in children. PEG is a nontoxic and highly soluble mingle that is not absorbed in the gastrointestinal tract. This mix without electrolytes, comes as a gunpowder that is palatable when dissolved in water or juice. PEG has prov to be effective in the short-term treatment of constipation in children, unless there currently are no published studies of long-term safety. Pashankar and colleagues evaluated the clinical and biochemical safety of long-term PEG therapy in children with chronic constipation. They also examined acceptance of this therapy in young children.

The trial was a prospective observational thought of children with chronic constipation, which was defined as at least three month of at least pair of the following symptoms: hard stools, encopresis, painful defecation, or fewer than three bowel manner of movings per week. After enrollment in the cogitation patients received PEG therapy at 08 g by means of kg per day, and use of other laxatives was stopped. Parents were instructed to dissolve 17 g of PEG comminute in 240 mL of water and give the appropriate amount of the liquid in brace divided doses. Parents could adjust the dosage until the child starting having couple soft, painless stools per day.

Parents were allowed to taper the dosage athwart time, based on the child's replication to therapy. Follow-up after the initiation of therapy was performed on giving parents a standard questionnaire that reviewed the dosage of PEG given, medication compliance, the beverage used to prepare PEG ease of mixing, overall improvement in bowel motions and any adverse effects. The children were asked whether they liked the medication and if they preferr it to other laxatives. posterity was obtained at the follow-up appointment to evaluate the biochemical power of PEG therapy.

There were 83 children who participated in the inquiry with an average age of 74 years (range, 20 to 169 years). The average duration of therapy for the close attention was 8.7 months (range, 3 to 30 months) The mean dosage of PEG was 075 g for kg per day. No serious adverse general intents were reported except for a transient elevation of the alanine transaminase plain in nine children that appeared to be unrelated to PEG therapy. Minor adverse drifts such as diarrhea were controll easily with a reduction in the dosage of PEG

Compared with previous laxatives, PEG was preferr at all of the children, and daily compliance was 90 percent in all of the children. Ninety-one percent of the caregivers reported a definite improvement in bowel-movement patterns with PEG therapy.

The authors deduce that PEG therapy is safe and well accepted in the long-term treatment of chronic constipation in children. They approve that PEG be considered first-line treatment in these patients because of its high rate of acceptability.

Pashankar D et al. Safety of polyethylene glycol 3350 for the treatment of chronic constipation in children. Arch Pediatr Adolesc M July 2003;157:661-4

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