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A prospective randomized study with mineral oil and oral lavage solution for treatment of faecal impaction in
1Division of Pediatric Gastroenterology and Nutrition, Children's Hospital of Michigan, Wayne State University, Detroit.
Insights
Mineral oil and polyethylene glycol (PEG) lavage solutions effectively treat faecal impaction. While PEG solution offers better clearance, mineral oil shows higher patient compliance due to fewer side effects like vomiting.
Area of Science:
- Pediatric Gastroenterology
- Clinical Pharmacology
Background:
- Faecal impaction is a prevalent pediatric condition.
- Effective treatment strategies are crucial for managing this condition and improving patient quality of life.
Purpose of the Study:
- To compare the efficacy and acceptability of mineral oil versus polyethylene glycol-3350 (Colyte) lavage solution for treating faecal impaction in patients over two years of age.
Main Methods:
- A randomized, open-label, prospective study involving 36 patients.
- Patients received either mineral oil (2-8 tablespoons twice daily for two days) or flavored PEG lavage solution (20 ml/kg/h for 4 hours on two consecutive days).
- Outcomes assessed included abdominal/rectal masses, perineal soiling, bowel movements, compliance, and side effects.
Main Results:
- The PEG lavage group demonstrated significantly more frequent bowel movements and superior clearance of abdominal and rectal masses (P < 0.01).
- However, patients in the lavage group experienced more vomiting and exhibited poorer treatment compliance (P < 0.01) compared to the mineral oil group.
Conclusions:
- Balanced lavage solutions effectively treat faecal impaction, offering significant clinical improvement.
- Mineral oil presents a more acceptable alternative due to better patient compliance, despite potentially less rapid clearance.
Abstract:
Faecal impaction with or without encopresis is a very common problem. We performed a randomized, open-label, prospective study to compare the efficacy and acceptability of the treatment of faecal impaction using either mineral oil or pineapple-flavoured isotonic intestinal lavage solution containing polyethylene glycol-3350 (Colyte). Thirty-six patients over 2 years of age were randomized to receive either mineral oil or flavoured lavage solution. The dose of mineral oil was 2 to 8 tablespoons twice a day for two days (17 patients--Group I) and of lavage solution was 20 ml/kg/h for 4 hours on two consecutive days (19 patients--Group II). The patients were assessed for the presence of abdominal faecal masses, presence and consistency of rectal mass, perineal soiling before and two days after either of the randomly assigned treatment. The patients and parents were asked regarding the compliance with treatment, side-effects, number of bowel movements after treatment and willingness to try similar treatment if faecal impaction recurred. Patients in the lavage group had more frequent bowel movements, and showed more effective clearance of abdominal and rectal lumps (P < 0.01) at the time of repeat examination at two days. However, they had some vomiting and were less compliant (P < 0.01) when compared to mineral oil patients. We conclude that balanced lavage solution effectively relieves faecal impaction, however, compliance with its use is poorer than that with mineral oil.