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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2014
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.
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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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