Background: Children with functional constipation and encopresis benefit from behavior modification and from long-term laxative medication. Polyethylene glycol without electrolytes has become the first option for many pediatric gastroenterologists.
Methods: Twenty-eight children treated with polyethylene glycol without electrolytes were compared with 21 children treated with milk of magnesia to evaluate the efficiency, acceptability, side effects, and treatment dosage of polyethylene glycol in long-term treatment of functional constipation and encopresis. Children were rated as “doing well,” “improved,” or “not doing well,” depending on resolution of constipation and encopresis.
Results: At the 1-, 3-, 6-, and 12-month follow-ups, bowel movement frequency increased and soiling frequency decreased significantly in both groups. At the 1-month follow-up, children on polyethylene glycol were soiling more frequently (P < 0.01) and fewer were improved (P < 0.01). At the 3- and 6-month follow-ups, both groups had similarly improved. At the 12-month visit, 61% of children on polyethylene glycol and 67% of children on milk of magnesia were doing well. Children on polyethylene glycol soiled more frequently (P < 0.01). None refused polyethylene glycol, but 33% refused to take milk of magnesia. The mean initial treatment dosage of polyethylene glycol was 0.6 ± 0.2 g/kg daily. Polyethylene glycol had no taste, and no loss of efficacy occurred. Polyethylene glycol did not cause clinically significant side effects.
Conclusions: Polyethylene glycol without electrolytes is an alternative for long-term management of children with constipation and encopresis.
Department of Pediatrics, University of Iowa, Iowa City, Iowa, U.S.A.
Received July 3, 2001; accepted January 7, 2002.
Presented in part at the American Gastroenterological Association Meeting, Atlanta, GA, May 22, 2001, and published as an abstract in Gastroenterology 2001;120(suppl 1):642A.
Dr. Loening-Baucke is currently the recipient of grant support from Braintree Pharmaceuticals, Braintree, MA, U.S.A., for continuing studies on childhood constipation.
Address correspondence and reprint requests to Dr. Vera Loening-Baucke, University of Iowa Hospitals and Clinics, Pediatrics, JCP 2555, 200 Hawkins Drive, Iowa City, IA 52242, U.S.A. (e-mail: email@example.com).