Original ArticlesEfficacy and optimal dose of daily polyethylene glycol 3350 for treatment of constipation and encopresis in children☆,☆☆
Section snippets
Study population
This study was approved by the institutional review board of the University of Iowa College of Medicine. Constipated children (n = 24) between the ages of 18 months and 12 years from the clinics at the University of Iowa Hospitals were enrolled. The diagnosis of chronic constipation was based on symptoms of at least 3 months' duration including at least 2 of the following: hard stools, painful defecation, withholding of stools, fecal soiling, palpable fecal mass, and fewer than 3 bowel
Effect of PEG on stool frequency, stool consistency, and soiling frequency
All 20 patients reported rapid improvement of bowel habits during PEG treatment; 12 patients noted improvement of stool frequency and consistency within 1 week, and the remaining 8 patients reported significant improvement during the second week. Fig 1 shows comparison of the stool frequency in 16 patients (excluding 4 patients with exclusive soiling) at enrollment with the stool frequency during the last 2 weeks of PEG therapy.
Discussion
The exact mechanism of constipation in children may vary among patients. Most cases are classified as “functional fecal retention” as described by the Rome II criteria.11 In such cases, pain caused by large, hard stools leads to fear of defecation and to voluntary stool withholding behavior.1 This results in prolonged fecal stasis in the colon and fecal impaction and may ultimately lead to overflow incontinence. Guidelines of the North American Society for Pediatric Gastroenterology and
Acknowledgements
We thank Dawyn Sawyer, PA, and Judith Heckman, PA, for their assistance in the study.
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Supported by Braintree Laboratories, Braintree, Massachusetts.
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Reprint requests: Warren P. Bishop, MD, Associate Professor of Pediatrics, Division of Gastroenterology, 2869 JPP, Children's Hospital of Iowa, 200 Hawkins Dr, Iowa City, IA 52242-1083.