Comparison of Polyethylene Glycol – Electrolyte Solution vs. Polyethylene Glycol – 3350 for the Treatment of Fecal Impaction in Pediatric Patients

Purpose: Functional constipation is common in pediatric patients and if untreated can lead to fecal impaction. Orally administered polyethylene glycol-electrolyte solution (PEG-ES) has been studied for efficacy in treatment of fecal impaction. Although it is effective, it is difficult to administer and is associated with side effects. Polyethylene glycol-3350 (PEG-3350), is more tolerable to patients and seems to be effective in treating fecal impaction. To date, there are no studies comparing these two treatment options. The aim of this study was to compare safety and efficacy of PEG-ES vs. PEG-3350 for the treatment of fecal impaction in pediatric patients.

Methods: Medical records from pediatric patients who received either PEG-ES or PEG-3350 for fecal impaction were included in this retrospective observational study.  Patients were excluded if they were discharged prior to resolution of symptoms, or if they were not receiving appropriate doses. Data collected included demographic data, treatment data, length of stay, time to resolution of symptoms, and side effects.

Results: Fifty-one patients were included for evaluation, 23 patients received PEG-ES and 28 patients received PEG-3350. Gender, race, age, and weight were not statistically different between the two groups. Resolution of fecal impaction was not significantly different between PEG-ES vs. PEG-3350, 87% and 86% respectively (p=0.87). There was only one reported side effect with PEG-3350 vs. 19 reported side effects with PEG-ES (p<0.01). Eighteen patients required NG tube placement for administration of PEG-ES and zero patients required NG placement for administration of PEG-3350 (p<0.01). 

Conclusion: This is the first reported comparison of the efficacy of PEG-ES and PEG-3350 for the treatment of fecal impaction in pediatric patients. PEG-3350 is as effective as PEG-ES for the treatment of fecal impaction in pediatric patients, PEG-3350 is associated with fewer side effects compared to PEG-ES, and PEG-3350 administration is less invasive to pediatric patients.