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A Retrospective Study Comparing Polyethylene Glycol-Electrolyte Solution With Magnesium Citrate for Treatment of
Lisa Philichi1, Melawati Yuwono
1Lisa Philichi, MN, ARNP, is Pediatric Nurse Practitioner, Pediatric Gastroenterology Clinic, Mary Bridge Children's Hospital and Health Center, Tacoma, Washington. Melawati Yuwono, MD, is Pediatric Gastroenterologist, Pediatric Gastroenterology Clinic, Mary Bridge Children's Hospital and Health Center, Tacoma, Washington.
Insights
Fecal disimpaction in children using nasogastric GoLYTELY or oral magnesium citrate showed similar effectiveness and time to achieve results. Magnesium citrate was less invasive and cheaper, despite some children finding it difficult to ingest.
Area of Science:
- Pediatric Gastroenterology
- Clinical Pharmacology
Background:
- Fecal impaction is a common pediatric issue requiring intervention.
- Hospitalized children with constipation may need fecal disimpaction for clinical improvement.
Purpose of the Study:
- To compare the efficiency of nasogastric GoLYTELY (polyethylene glycol-electrolyte solution) versus oral magnesium citrate for fecal disimpaction in children.
- To evaluate treatment time, enema requirements, and success rates of two disimpaction methods.
Main Methods:
- Retrospective chart review of 103 pediatric patients (age 1-18 years) undergoing fecal disimpaction.
- Comparison of nasogastric polyethylene glycol-electrolyte (n=46) and oral magnesium citrate (n=57) treatments.
- Assessment of time to successful stool evacuation via abdominal radiograph, enema use, and adverse events.
Main Results:
- Both nasogastric polyethylene glycol-electrolyte and magnesium citrate treatments required similar times for cleanout (average 5h 15m vs. 5h 30m).
- Nasogastric polyethylene glycol-electrolyte required an average of 2.5 enemas, while magnesium citrate required 3.0.
- Success rates were comparable (85% for nasogastric polyethylene glycol-electrolyte, 90% for magnesium citrate), with vomiting noted in both groups.
Conclusions:
- Nasogastric polyethylene glycol-electrolyte and oral magnesium citrate are similarly effective for pediatric fecal disimpaction in terms of time and success.
- Magnesium citrate is a less invasive and more cost-effective option, though palatability can be a challenge.
- Both treatments are viable options for hospital-based fecal disimpaction in children.
Abstract:
Fecal disimpaction in the hospital setting may be necessary for a constipated child's condition to improve. This study evaluated the efficiency of 2 disimpaction therapies: nasogastric GoLYTELY (polyethylene glycol-electrolyte solution) compared with oral magnesium citrate. Retrospective chart review of 103 children was conducted to determine the time from the start of the clinic cleanout until abdominal radiograph verification of successful stool evacuation. The children were in an age range of 1-18 years, with average age of 8 years. Forty-five were female and 59 were male. Forty-six (45%) children received nasogastric polyethylene glycol-electrolyte and 57 (55%) drank magnesium citrate. The children receiving nasogastric polyethylene glycol-electrolyte on average required 2.5 enemas, and the children receiving magnesium citrate required 3.0 enemas. The average time for a nasogastric polyethylene glycol-electrolyte cleanout was 5 hours 15 minutes (range: 3 hours 30 minutes to 7 hours) and 5 hours 30 minutes for magnesium citrate cleanout (range: 2 to 8 hours). Seven (15%) children who received nasogastric polyethylene glycol-electrolyte and 6 (10%) of those who drank magnesium citrate did not achieve clearance of stool on the second radiograph. Vomiting was an adverse effect of both medications, and 7 (12%) children were unable to drink the entire magnesium citrate dose. Both methods of disimpaction take the same amount of time. Magnesium citrate can be difficult to drink; however, it is less invasive and less costly than nasogastric polyethylene glycol-electrolyte.
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