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A comparison of cathartics in pediatric ingestions

L P James1, M H Nichols, W D King

  • 1Department of Pediatrics, University of Alabama at Birmingham, USA.

Pediatrics
|August 1, 1995
PubMed

Insights

In pediatric ingestions, sorbitol with activated charcoal significantly reduced the time to the first stool and increased stool frequency compared to other cathartics. However, sorbitol also led to more instances of emesis.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Pharmacology
  • Toxicology

Background:

  • Cathartics are frequently used in pediatric ingestions to enhance elimination of toxic substances.
  • Limited comparative data exists on the efficacy and safety of commonly used cathartics in this population.

Purpose of the Study:

  • To compare the efficacy of sorbitol, magnesium citrate, and magnesium sulfate as cathartics in pediatric acute ingestions.
  • To evaluate the time to first stool, stool frequency, and incidence of side effects.

Main Methods:

  • A prospective, randomized, double-blinded clinical trial involving pediatric patients aged 1 to 5 years with acute ingestions.
  • Patients received activated charcoal with either sorbitol, magnesium citrate, magnesium sulfate, or water.
  • Outcomes measured included mean time to first stool and mean number of stools within 24 hours.

Main Results:

  • Sorbitol administration resulted in a significantly shorter mean time to the first stool (8.48 hours) compared to other agents.
  • Sorbitol also produced a significantly higher mean number of stools (2.79) in the 24-hour period.
  • Emesis was the most frequent side effect, occurring more often in the sorbitol group.

Conclusions:

  • Sorbitol is an effective cathartic in pediatric acute ingestions, promoting faster and more frequent bowel movements when combined with activated charcoal.
  • While effective, the increased incidence of emesis with sorbitol warrants consideration in clinical decision-making.
Abstract

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