Medline ® Abstracts for References 3,4
of 'Chronic functional constipation and fecal incontinence in infants and children: Treatment'
Polyethylene glycol for constipation in children younger than eighteen months old.
Michail S, Gendy E, Preud'Homme D, Mezoff A
J Pediatr Gastroenterol Nutr. 2004;39(2):197.
BACKGROUND: Polyethylene glycol (PEG) is a safe and effective treatment for constipation in children older than 18 months. Data on its safety and efficacy in infants are lacking. The goal of this study was to determine safety, efficacy, and optimal dose of polyethylene glycol powder for treatment of constipation in patients younger than 18 months.
METHODS: The authors reviewed the charts of patients younger than 18 months treated with PEG 3350 for constipation. The initial dose, effective maintenance dose, response to therapy, duration of therapy, and side effects were recorded.
RESULTS: Twenty-eight patients younger than 18 months of age treated with PEG were identified (3, age 0-5 months; 9, age 6-11 months; 16, age 12-17 months). Mean duration of therapy was 6.2 +/- 5 months (range, 3 weeks-21 months). Mean initial dose was 0.88 g/kg/day (range, 0.26-2.14 g/kg/day). Mean effective maintenance dose was 0.78 g/kg/day (range, 0.26-1.26 g/kg/day). PEG relieved constipation in 97.6% of patients. One infant experienced increased gas per rectum and four others experienced transient diarrhea that resolvedafter adjusting the dose.
CONCLUSION: Oral powdered polyethylene glycol at a maintenance dose of 0.78 g/kg/day is safe and effective for patients younger than 18 months. Dose and safety profiles are similar for those reported in older children.
Wright State University School of Medicine and The Children's Medical Center, Dayton, Ohio 45404, USA. email@example.com
Polyethylene glycol 3350 without electrolytes for the treatment of functional constipation in infants and toddlers.
Loening-Baucke V, Krishna R, Pashankar DS
J Pediatr Gastroenterol Nutr. 2004;39(5):536.
OBJECTIVES: We have recently reported the safety and efficacy of polyethylene glycol 3350 without electrolytes (PEG) for the daily treatment of constipation in older children. Because there are very few data available on the use of PEG in infants and toddlers, we evaluated the efficacy and safety of PEG for the treatment of constipation in children<2 years of age.
METHODS: This is a retrospective chart review of 75 constipated children<2 years of age at start of PEG therapy. PEG was started at an average dose of 1 g/kg body weight/d and parents were asked to adjust the dose to yield 1 to 2 soft painless stools/d. Data from the history and physical examination were collected initially and at short-term (<or=4 months) and long-term (>or=6 months) follow-up.
RESULTS: 75 otherwise healthy children received PEG for functional constipation. The mean age was 17 months (range, 1 to 24 months) and the mean duration of constipation was 10 months (range, 0.5 to 23 months). The mean duration of short-term follow-up was 2 months and mean duration of long-term follow-up was 11 months. The mean effective short-term PEG dose was 1.1 g/kg body weight/d and the mean long-term dose was 0.8 g/kg body weight/d. Constipation was relieved in 85% with short-term and in 91% with long-term PEG therapy. Adverse effects were mild and included diarrhea, which disappeared with lowering the dose. No subjects stopped PEG because of adverse effects.
CONCLUSION: PEG is effective, well tolerated and appeared safe for the treatment of functional constipation in children<2 years of age.
Division of General Pediatrics, University of Iowa, Iowa City 52242-1083, USA. firstname.lastname@example.org