The purpose of a recent study published in Pediatric Gastroenterology, Hepatology & Nutrition was to evaluate the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction, in hospitalized children.

This retrospective study recruited 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d). Additionally, an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in nine patients.

It was observed that after disimpaction, the frequency of defecation increased from 2.2±0.3 per week to once a day (1.1±0.1 per day). The number of patients who complained of abdominal pain was reduced from 53.6% to 14.3%. From the CTT test results, 55.6% were classified as belonging to a group showing abnormalities. While in some patients, mild adverse effects were noted, no abnormalities were detected with respect to electrolytes and osmolality before and after disimpaction, in 16 of the children.

From the findings, it was inferred that regarding therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.