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Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children: A Meta-Analysis
Constipation is a common childhood complaint. In 90% to 95% of children, constipation is functional, which means that there is no objective evidence of an underlying pathological condition. Polyethylene glycol (PEG or macrogol) solution is an osmotic laxative agent that is absorbed in only trace amo...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616298/ https://www.ncbi.nlm.nih.gov/pubmed/25310742 http://dx.doi.org/10.1097/MD.0000000000000065 |
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author | Chen, Si-Le Cai, Shi-Rong Deng, Liang Zhang, Xin-Hua Luo, Te-Dong Peng, Jian-Jun Xu, Jian-Bo Li, Wen-Feng Chen, Chuang-Qi Ma, Jin-Ping He, Yu-Long |
author_facet | Chen, Si-Le Cai, Shi-Rong Deng, Liang Zhang, Xin-Hua Luo, Te-Dong Peng, Jian-Jun Xu, Jian-Bo Li, Wen-Feng Chen, Chuang-Qi Ma, Jin-Ping He, Yu-Long |
author_sort | Chen, Si-Le |
collection | PubMed |
description | Constipation is a common childhood complaint. In 90% to 95% of children, constipation is functional, which means that there is no objective evidence of an underlying pathological condition. Polyethylene glycol (PEG or macrogol) solution is an osmotic laxative agent that is absorbed in only trace amounts from the gastrointestinal tract and routinely used to treat chronic constipation in adults. Here, we report the results of a meta-analysis of PEG-based laxatives compared with lactulose, milk of magnesia (magnesium hydroxide), oral liquid paraffin (mineral oil), or acacia fiber, psyllium fiber, and fructose in children. This meta-analysis was conducted in accordance with PRISMA guidelines and involved searches of MEDLINE, Cochrane, EMBASE, and Google Scholar databases up to February 10, 2014, using the keywords (Constipation OR Functional Constipation OR Fecal Impaction) AND (Children) AND (Polyethylene Glycol OR Laxative). Primary efficacy outcomes included a number of stool passages/wk and percentage of patients who reported satisfactory stool consistency. Secondary safety outcomes included diarrhea, abdominal pain, nausea or vomiting, pain or straining at defecation, bloating or flatulence, hard stool consistency, poor palatability, and rectal bleeding. We identified 231 articles, 27 of which were suitable for full-text review and 10 of which were used in the meta-analysis. Patients who were treated with PEG experienced more successful disimpaction compared with those treated with non-PEG laxatives. Treatment-related adverse events were acceptable and generally well tolerated. PEG-based laxatives are effective and safe for chronic constipation and for resolving fecal impaction in children. Children’s acceptance of PEG-based laxatives appears to be better than non-PEG laxatives. Optimal dosages, routes of administration, and PEG regimens should be determined in future randomized controlled studies and meta-analyses. |
format | Online Article Text |
id | pubmed-4616298 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-46162982015-10-27 Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children: A Meta-Analysis Chen, Si-Le Cai, Shi-Rong Deng, Liang Zhang, Xin-Hua Luo, Te-Dong Peng, Jian-Jun Xu, Jian-Bo Li, Wen-Feng Chen, Chuang-Qi Ma, Jin-Ping He, Yu-Long Medicine (Baltimore) Article Constipation is a common childhood complaint. In 90% to 95% of children, constipation is functional, which means that there is no objective evidence of an underlying pathological condition. Polyethylene glycol (PEG or macrogol) solution is an osmotic laxative agent that is absorbed in only trace amounts from the gastrointestinal tract and routinely used to treat chronic constipation in adults. Here, we report the results of a meta-analysis of PEG-based laxatives compared with lactulose, milk of magnesia (magnesium hydroxide), oral liquid paraffin (mineral oil), or acacia fiber, psyllium fiber, and fructose in children. This meta-analysis was conducted in accordance with PRISMA guidelines and involved searches of MEDLINE, Cochrane, EMBASE, and Google Scholar databases up to February 10, 2014, using the keywords (Constipation OR Functional Constipation OR Fecal Impaction) AND (Children) AND (Polyethylene Glycol OR Laxative). Primary efficacy outcomes included a number of stool passages/wk and percentage of patients who reported satisfactory stool consistency. Secondary safety outcomes included diarrhea, abdominal pain, nausea or vomiting, pain or straining at defecation, bloating or flatulence, hard stool consistency, poor palatability, and rectal bleeding. We identified 231 articles, 27 of which were suitable for full-text review and 10 of which were used in the meta-analysis. Patients who were treated with PEG experienced more successful disimpaction compared with those treated with non-PEG laxatives. Treatment-related adverse events were acceptable and generally well tolerated. PEG-based laxatives are effective and safe for chronic constipation and for resolving fecal impaction in children. Children’s acceptance of PEG-based laxatives appears to be better than non-PEG laxatives. Optimal dosages, routes of administration, and PEG regimens should be determined in future randomized controlled studies and meta-analyses. Wolters Kluwer Health 2014-10-03 /pmc/articles/PMC4616298/ /pubmed/25310742 http://dx.doi.org/10.1097/MD.0000000000000065 Text en © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial License, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be used commercially. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | Article Chen, Si-Le Cai, Shi-Rong Deng, Liang Zhang, Xin-Hua Luo, Te-Dong Peng, Jian-Jun Xu, Jian-Bo Li, Wen-Feng Chen, Chuang-Qi Ma, Jin-Ping He, Yu-Long Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children: A Meta-Analysis |
title | Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children: A Meta-Analysis |
title_full | Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children: A Meta-Analysis |
title_fullStr | Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children: A Meta-Analysis |
title_full_unstemmed | Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children: A Meta-Analysis |
title_short | Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children: A Meta-Analysis |
title_sort | efficacy and complications of polyethylene glycols for treatment of constipation in children: a meta-analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616298/ https://www.ncbi.nlm.nih.gov/pubmed/25310742 http://dx.doi.org/10.1097/MD.0000000000000065 |
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