Constipation is a common cause for hospitalization of children for fecal disimpaction.

The purpose of a recent study published in the Journal of Paediatrics and Child Health was to assess the effectiveness of a high-dose oral protocol using polyethylene glycol with electrolytes (PEG + E) combined with sodium picosulphate (SP) in the management of fecal impaction in children.

This was a retrospective study wherein 44 children, in the age-range of 2-17 years, with acute or chronic fecal impaction were administered six to eight sachets of PEG+E on the first day, with decreasing doses on subsequent 3 days. Additionally, 15-20 drops of SP were given to these children on the second and the third day. From the fourth day, an ongoing maintenance dose was commenced with PEG+E one sachet and SP to 10 drops, on a daily basis. Defecation, soiling, diet and water intake was monitored daily for 7 consecutive days. Children were followed up over 8 months.

It was observed that children began defecating within 10-12 hours after the initiation of therapy. On the second day of the intervention, a maximum daily volume of stool could be achieved. All patients were disimpacted successfully and there was no incidence of fecal soiling or complications during the study period.

From the results, it was inferred that a high-dose oral protocol combining PEG+E sachets and SP drops can successfully and safely disimpact children with acute or chronic constipation. It was stated that this protocol is useful in controlling fecal disimpaction in an outpatient setting and could prevent hospitalization of children due to fecal impaction.