Efficacy and Safety of Combined Oral and Enema Therapy Using Polyethylene Glycol 3350-Electrolyte for Disimpaction in Pediatric Constipation
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Purpose: We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. Methods: We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d), and an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients. Results: Administration of oral and enema doses of PEG 3350 electrolyte solution showed 2.1±0.3 times and 2.9±0.4times, respectively. After disimpaction, the frequency of defecation increased from 2.2±0.3 per week to once a day (1.1±0.1 per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted.Conclusion: In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.
Abstract
Purpose: We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. Methods: We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d), and an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients. Results: Administration of oral and enema doses of PEG 3350 electrolyte solution showed 2.1±0.3 times and 2.9±0.4times, respectively. After disimpaction, the frequency of defecation increased from 2.2±0.3 per week to once a day (1.1±0.1 per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted.Conclusion: In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.
참고문헌 (23)
- Loening-Baucke V, "Constipation as cause of acute abdominal pain in children", J Pediatr, 151, pp.666~669 (2007)
- van den Berg MM, "Epidemiology of childhood constipation: a systematic review", Am J Gastroenterol, 101, pp.2401~2409 (2006)
- Alper A, "Polyethylene glycol: a gamechanger laxative for children", J Pediatr Gastroenterol Nutr, 57, pp.134~140 (2013)
- Pashankar DS, "Childhood constipation: evaluation and management", Clin Colon Rectal Surg, 18, pp.120~127 (2005)
- Bekkali NL, "Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG", Pediatrics, 124, pp.e1108~e1115 (2009)
- Tabbers MM, "Evaluation and treatment of functional constipation in infants and children:evidence-based recommendations from ESPGHAN and NASPGHAN", J Pediatr Gastroenterol Nutr, 58, pp.258~274 (2014)
- Kliegman RM, "Nelson textbook of pediatrics", pp.3473~ (2016), Elsevier
- Rasquin A, "Childhood functional gastrointestinal disorders: child", adolescent, 2006, pp.130, 1527~1537
- Hyman PE, "Childhood functional gastrointestinal disorders: neonate", toddler, 2006, pp.130, 1519~1526
- 이정희, "소아 만성 기능성변비 치료에서 전해질이 함유되지 않은Polyethylene glycol (PEG) 4000의 분변박힘 제거효과 및 안전성", Korean Journal of Pediatrics, 51(4), pp.391~395 (2008), 대한소아과학회
- Metcalf AM, "Simplified assessment of segmental colonic transit", Gastroenterology, 92, pp.40~47 (1987)
- Ha Yeong Yoo, "Colon Transit Time Test in Korean Children with Chronic Functional Constipation", Pediatric Gastroenterology, Hepatology & Nutrition, 19(1), pp.38~43 (2016), 대한소아소화기영양학회
- Feldman M, "Sleisenger & Fordtran's gastrointestinal and liver disease", pp.270~296 (2010), Saunders
- Hyams JS, "Childhood functional gastrointestinal disorders: child", adolescent, 2016, pp.150, 1456~1468.e2
- Miller MK, "A randomized trial of enema versus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department", Pediatr Emerg Care, 28, pp.115~119 (2012)
- Lee-Robichaud H, "Lactulose versus polyethylene glycol for chronic constipation", Cochrane Database Syst Rev, (7), pp.CD007570~ (2010)
- Phatak UP, "Role of polyethylene glycol in childhood constipation", Clin Pediatr (Phila), 53, pp.927~932 (2014)
- Youssef NN, "Dose response of PEG 3350 for the treatment of childhood fecal impaction", J Pediatr, 141, pp.410~414 (2002)
- Katelaris P, "Comparison of the effectiveness of polyethylene glycol with and without electrolytes in constipation: a systematic review and network meta-analysis", BMC Gastroenterol, 16, pp.42~ (2016)
- Boles EE, "Comparison of polyethylene glycol-electrolyte solution vs polyethylene glycol-3350 for the treatment of fecal impaction in pediatric patients", J Pediatr Pharmacol Ther, 20, pp.210~216 (2015)
- 배선환, "Long-term safety of PEG 4000 in children with chronic functional constipation: A biochemical perspective", Korean Journal of Pediatrics, 53(7), pp.741~744 (2010), 대한소아과학회
- Pashankar DS, "Safety of polyethylene glycol 3350 for the treatment of chronic constipation in children", Arch Pediatr Adolesc Med, 157, pp.661~664 (2003)
- Beckmann KR, "Accuracy of clinical variables in the identification of radiographically proven constipation in children", WMJ, 100, pp.33~36 (2001)