IJCM  Vol.3 No.5 , September 2012
A Comparative Trial: The Safety and Clinical Efficacy of PEG 3350 and Liquid Paraffin in Management of Chronic Functional Constipation in Children
ABSTRACT
Background: Constipation is one of the most common problems in the pediatric age group. In the vast majority, chronic constipation is idiopathic or functional. In addition to education and behavioral changes, disimpaction and maintenance treatment with medications are the main pillars of successful outcome. The medications are variably effective and have potential side effects. Objectives: The current clinical trial was designed to evaluate clinical efficacy of polyethylene glycol (PEG) 3350 and liquid paraffin in chronic functional constipation. Besides, subjects were followed carefully for the side effects. Material and Methods: This study was involved 110 children suffering from chronic functional constipation. They were placed into two different groups, randomly. Each group was treated with PEG 3350 or liquid paraffin. The clinical efficacy and side effects were monitored. Results: After disimpaction with bisacodyl suppositories or combined with Mineral oil enemas in hard fecal impaction, maintenance therapy with PEG 3350 or liquid paraffin was started. The treatment duration and efficacies were not different between the two groups. Furthermore, serious adverse drug reaction was not observed. The family history of constipation and presence of incontinence were two worse prognostic factors. Conclusion: No difference was observed between PEG 3350 and liquid paraffin in chronic functional constipation in children in terms of their efficacies. They are safe and effective medications in this age group.

Cite this paper
A. Parvin, A. Farzaneh and H. Nasab Ali, "A Comparative Trial: The Safety and Clinical Efficacy of PEG 3350 and Liquid Paraffin in Management of Chronic Functional Constipation in Children," International Journal of Clinical Medicine, Vol. 3 No. 5, 2012, pp. 383-386. doi: 10.4236/ijcm.2012.35072.
References
[1]   T Rahhal, R. and A. UC, Motility Disorders,Functional Constipation, in Walker’s pediatric gastrointestinal disorders, S.I. Kleinman RE, Goulet O, et al, Editor. 2008, Hamilton: BC Decker Inc. p. 675-682.

[2]   Loening-Baucke, V., Constipation and Encopresis, in Pediatric gastrointestinal and liver disease, H.J. Wyllie R, Editor. 2006, Saunders Elsevier: Philadelphia. p. 177-191.

[3]   Mugie SM, Benninga MA and DI Lorenzo C. Epidemiology of constipation in children and adults: a ssystematic review. Best Pract Res Clin Gastroenterol. 2011Feb; 25(1): 3-18.

[4]   Youseff N, Peters JM, Henderson W, Shultz-Peters S, Lockhart DK and Di Lorenzo C. Dose response of PEG 3350 for the treatment of childhood fecal impaction.J Pediatr 2002; 141(3): 410-4.

[5]   Tolia V. Use of a balanced lavage solution in the treatment of fecal impaction.J Pediatr Gastroenterol Nutr 1988; 7(2): 299-301.

[6]   Tolia V, Lin CH, Elitsur Y. A prospective randomized study with mineral oin and oral lavage solution for treatment of faecal impaction in children. Aliment Pharmacol Ther 1993; 7(5): 523-9.

[7]   Pijers MA, Tabbers MM, Benninga MA and Berger MY. Currently recommended treatments of childhood constipation are not evidence-based, a systematic literature review on the effect of laxative treatment and dietary measures. Arch Dis Child. 2009 Feb; 94(2): 117-31

[8]   Urganci N, Akyildiz B and Polat TB. A comparative study: the efficacy of liquid paraffin and lactulose in management of chronic functional constipation. Pediatr Int.2005Feb; 47(1): 15-9.

[9]   Bell EA and Wall GC. Pediatric constipation therapy using guidelines and polyethylene glycol 3350. Ann Pharmacother.2004 Apr; 38(4): 686-93.

[10]   Voskuij I, De lorijn F, Verwijs W Hogeman P, Heijmans J, Mokel W, Taminiau J and Benninga M. PEG 3350(Transipeg) versus lactulose in the treatment of childhood functional constipation: a double-blind, randomized, controlled, multicenter trial. Gut 2004 Nov; 53(11): 1590-4.

[11]   Dupont C, Leluyer B, Amar F, Kalach N, Benhamou PH, Mouterde O and Vannerom PY. A dose determination study of polyethylene glycol 4000 in constipated children: factors influencing the maintenance dose. JPGN 2006 Feb; 42(2): 178-85.

[12]   Nurko S, Youssef NN, Sabri M and Langseder A, McGowan J, Cleveland M and Di Lorenzo C. PEG 3350 in the treatment of childhood constipation: a multicenter, double-blinded, placebo-controlled trial. J Pediatr. 2008Aug; 153(2): 254-61, 261, e1.EPub 2008 March 19.

[13]   Dipalma JA, Cleveland MB, MC Gowan and Herrera JL. A comparison polyethylene glycol laxative and placebo for relief of constipation from constipating medications. South Med J. 2007 Nov; 100 (11): 1085-90.

[14]   Karami H, Khademlo M and Niari P. Polyethylene glycol versus paraffin for the treatment of childhood functional constipation. Iran J Pediatr. 2009Sep; 19(3): 255-61.

[15]   Pashankar DS, Bishop WP. Efficacy and optimal dose of daily polyethylene glycol 3350 for treatment of constipation and encopresis in children. J Pediatr 2001; 139(3):428-32.

[16]   Pina DI, Barba MM, Canton OS,Beltran MA, Ferreiro SR, Casas RV and Rey JL. Safety and efficacy of polyethylene glycol 3350 plus electrolyes for the treatment of functional constipation in children. An Pediatr (Barc). 2011 Aug; 75(2): 89-95.

[17]   Bae SH. Long-term safety PEG 4000 in children with chronic functional constipation: A biochemical perspective. Korean J Pediatr. 2010 July; 53(7): 741-4.

[18]   Sondheimer JM and Gervaise EP. Lubricant versus laxative in the treatment of chronic functional constipation of children: a comparative study. JPGN. 1982; 1(2): 223-6.

[19]   Gomes PB, Duarte MA, Melo Mdo C. Comparison of the effectiveness of polyethylene glycol 4000 without electrolytes and magnesium hydroxide in the treatment of chronic functional constipation in children. J Pediatr (Rio J). 2011 Jan-Feb; 87(1): 24-8.

 
 
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