Constipation is one of the most frequent gastrointestinal complaints, which occurs when bowel movements become less frequent, and stools become difficult to pass. Generally, it is elicited by certain medications, aging factors, changes in diet or routine, or due to inadequate intake of fiber. However, this condition may become chronic when the malady persists for several weeks or longer. Extreme and severe cases of constipation can lead to fecal impaction. Fecal impaction is a chronic gastrointestinal disorder manifested by the formation of a large lump of dry, hard stool that sticks in the rectum. FIs are most common in the elderly population and are a potential source of severe morbidity. Most cases of mild to moderate constipation can be self-managed, but the chronic conditions and fecal impaction need appropriate medical assistance. The current therapies for treating constipation and fecal impaction are often unpleasant and futile. 

This study aims to evaluate the efficacy and safety of Movicol, which is polyethylene glycol and electrolyte solution (PEG+E), for treating severe constipation and fecal impaction. The trial involves a systematic review of 56 patients (aged 17 to 88 years) with a history of chronic constipation. A thorough abdominal and rectal examination, along with abdominal radiography, was carried out to diagnose fecal impaction. Patients were excluded from the study if they had a gastrointestinal obstruction, evidence of delayed gastric emptying, or if their constipation was secondary to severe inflammatory bowel disease. The treatment included the oral administration of two sachets of 13.8g of PEG+E in 250 ml water over a 4-6 h period each day, with 1-1.5 h between each dosing, for up to three days. The data was recorded based on bowel movements of the patients in terms of stool volume, the number of evacuations, stool form, and ease of evacuations.

The results revealed that 89.3% of the trial patients successfully responded to the treatment. All bowel movement measurements showed an improvement by Day 2. The incidence of adverse events was low, without any symptoms of abdominal pain and bloating, which are the most common undesirable consequences of PEG+E administration. No patient was discontinued from the study because of an adverse event.

Thus, it can be concluded that PEG+E, administered orally at a dose equivalent to eight 13.8 g sachets (1L) per day over three days, was a highly effective and well-tolerated therapy for the treatment of severe constipation and fecal impaction.

Keywords: Constipation, Fecal Impaction, Movicol, Polyethylene Glycol

Source –Chun-Chia Chen, Ming-Yao Su, Shui-Yi Tung, Full‐Yang Chang, Jau-Min Wong & Mike Geraint; Evaluation of polyethylene glycol plus electrolytes in the treatment of severe constipation and faecal impaction in adults, Current Medical Research and Opinion, (2005); 21:10, 1595-1602.