Polyethylene glycol 4000 for treatment of functional constipation in children

Area of Science:

• Pediatric Gastroenterology
• Pharmacology

Background:

• Functional constipation is a common pediatric condition.
• Polyethylene glycol (PEG) is a widely used osmotic laxative for constipation management in children.

Purpose of the Study:

• To compare the efficacy and safety of two different doses of polyethylene glycol 4000 (PEG 4000) for the maintenance treatment of functional constipation in pediatric patients.
• To evaluate treatment success rates, need for therapy adjustment, and adverse events associated with different PEG 4000 dosages.

Main Methods:

• A randomized controlled trial involving children diagnosed with functional constipation based on Rome III criteria.
• Participants received either high-dose (0.7 g/kg) or low-dose (0.3 g/kg) PEG 4000 for six weeks.
• Treatment success was defined as achieving at least three bowel movements per week without fecal soiling in the final week.

Main Results:

• Treatment success rates were comparable between the high-dose and low-dose PEG groups (Relative Risk 0.9, 95% CI 0.78-1.03).
• The low-dose group showed a borderline significant increase in the need for therapy adjustment (Relative Risk 2.0, 95% CI 1.0-4.2), experienced more painful defecation, had fewer stools weekly, and reported lower parental satisfaction.
• Adverse events were similar across both treatment groups.

Conclusions:

• Both tested doses of polyethylene glycol (PEG) demonstrated equal safety and effectiveness for achieving treatment success in pediatric functional constipation.
• While effective, the lower PEG dose necessitated more frequent therapeutic adjustments and was associated with less favorable outcomes in terms of stool frequency and parental satisfaction.