P0474 POLYETHYLENE GLYCOL WITHOUT ELECTROLYTES FOR THE TREATMENT OF CONSTIPATION IN INFANTS AND TODDLERS

Abstract

Introduction: We have recently reported safety and efficacy of polyethylene glycol 3350 without electrolytes (PEG) for the daily treatment of constipation in school-aged children. We evaluated the efficacy and safety of PEG for the treatment of constipation in children <2 years of age. Methods: Retrospective chart review of consecutive constipated children, <2 years of age at start of PEG therapy. PEG was started at an average dose of 1 g/kg body weight/day and parents were asked to adjust the dose to yield 1 to 2 soft painless bowel movements (BMs) per day. Data pre-PEG were compared to similar parameters on short-term (<4 months) and long-term PEG (>4 months). Results: 74 children (47% males) received PEG for constipation, 66 were otherwise healthy and 8 were neurological impaired to devastated. The mean age was 17 months (range 2 to 24) and the mean duration of constipation was 11 months (range 1.5 to 34). The mean duration of follow-up for short-term PEG was 3 months (range 0.5 to <4), for long-term PEG was 11 months (range 4 to 35), and the mean number of outpatient visits was 3 (range 2 to 7). After adjustment, the mean effective short-term PEG dose was 1.1 g/kg/day and the long-term PEG dose was 0.8 g/kg/day (range 0.3 to 1.9). As shown in Table 1, significant improvements in all parameters were achieved with short-term and long-term PEG therapy. Adverse effects were mild and included diarrhoea in 5 short-term, which disappeared with lowering the dose, and in one at 6-month. None stopped PEG due to adverse effects.Table 1Conclusion: PEG is effective for the treatment of functional constipation in children <2 years of age. The average effective dose was 1.1 g/kg/day at short-term and 0.8 g/kg/day at long-term follow-up. The range was quite wide, indicating the need for adjusting the dose on an individual basis. PEG was well tolerated and appeared to be safe in our infants and toddlers.