Extreme and severe cases of constipation can cause faecal impaction. The current therapies addressing this issue are ineffective and unpleasant. 

The present study evaluated the efficacy and safety of Movicol, a polyethylene glycol (PEG) + electrolyte solution (PEG+E), for treating severe constipation and faecal impaction. It enrolled 56 patients (aged 17 to 88 years) with a history of chronic constipation and with no bowel movement for three to four days (severe constipation) or at least five days (faecal impaction). It confirmed Faecal loading in all patients by abdominal and rectal examination or abdominal radiography. 

The study excluded Patients with gastrointestinal obstruction, evidence of delayed gastric emptying, or if their constipation was secondary to severe inflammatory bowel disease. All patients received the same regimen: up to eight 13.8 g sachets of PEG+E (two sachets in 250 ml water at a time; maximum of 1L/day) over a 4-6 h period each day, with 1-1.5 h between each dosing, for up to three days. 

It defined responders as the patients with either improvement (passage of a moderate to a large volume of stool within four days of treatment initiation) or complete resolution (passage of moderate to large volumes of faecal matter along with the elimination of palpable faecal masses in the abdomen and/or rectum).

The observations were as follows-

• Based on bowel movement data recorded by the patients, the study found an excellent response rate, with 89.3% of patients showing a successful response to treatment, including complete responders and those with improvement.
• Investigator response assessment was also nearly the same: 87.5%.
• All bowel movement measurements (stool volume, number of evacuations, stool form, and ease of evacuations) improved by Day 2.
• The median duration of treatment was two days.
• There was a low incidence of adverse events, including side effects such as abdominal pain and bloating, which are the known undesirable consequences of PEG+E administration.
• No patient discontinued the study due to adverse events. 

Thus, this study concluded that PEG+E, administered orally at a dose equivalent to eight 13.8 g sachets (1 L)/day for three days, is a highly effective and well-tolerated therapy for treating severe constipation and faecal impaction.

Current Medical Research and Opinion.2005;21(10):1595-1602.