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dc.contributor.authorLamanna, A
dc.contributor.authorDughetti, LD
dc.contributor.authorJordan-Ely, JA
dc.contributor.authorDobson, KM
dc.contributor.authorDynan, M
dc.contributor.authorFoo, A
dc.contributor.authorKooiman, LMP
dc.contributor.authorMurakami, N
dc.contributor.authorFiuza, K
dc.contributor.authorForoughi, S
dc.contributor.authorLeal, M
dc.contributor.authorVidmar, S
dc.contributor.authorCatto-Smith, AG
dc.contributor.authorHutson, JM
dc.contributor.authorSouthwell, BR
dc.date.accessioned2020-12-09T23:43:23Z
dc.date.available2020-12-09T23:43:23Z
dc.date.issued2018-08-01
dc.identifierpii: JGH312062
dc.identifier.citationLamanna, A., Dughetti, L. D., Jordan-Ely, J. A., Dobson, K. M., Dynan, M., Foo, A., Kooiman, L. M. P., Murakami, N., Fiuza, K., Foroughi, S., Leal, M., Vidmar, S., Catto-Smith, A. G., Hutson, J. M. & Southwell, B. R. (2018). Treatment of fecal impaction in children using combined polyethylene glycol and sodium picosulphate. JGH OPEN, 2 (4), pp.144-151. https://doi.org/10.1002/jgh3.12062.
dc.identifier.issn2397-9070
dc.identifier.urihttp://hdl.handle.net/11343/253307
dc.description.abstractBackground and Aim: Polyethylene glycol (PEG) is the gold standard for fecal disimpaction in constipation. A regimen of PEG combined with the stimulant laxative sodium picosulphate (SPS) produced fecal disimpaction in chronically constipated children in the community, but it is unknown if it is effective for more severe constipation. To determine the stool output and effect of a combined PEG and SPS regimen on fecaloma in children with severe constipation and impaction. Methods: Children with symptoms for a duration of ≥2 years, a palpable fecaloma, and enlarged rectum on X-ray (rectal: pelvic ratio > 0.6) were recruited from a tertiary hospital. Daily diaries recorded laxative dose, stool frequency, volume, and consistency (Bristol stool scale, BSS). Abdominal X-rays were taken on day 1 and day 8, and stool loading was assessed using the Leech score. Laxative doses were based on the child's age. The dose of PEG with electrolytes taken was 2-8 sachets (14.7 g/sachet) on days 1-2, reducing to 2-6 sachets on day 3. The SPS dose was 15-20 drops on days 2-3. Results: Eighty-nine children (4-18 years) produced a large volume of soft stool (median/inter-quartile-range: 2.2/1.6-3.1 L) over 7 days. Stool volume on X-rays decreased significantly in the colon (P < 0.001). Fecalomas resolved in 40 of 89 children, while 49 needed a second high dose. Rectal:pelvic ratios did not change. Conclusions: A combined high dose of PEG and SPS on days 1 and 2 was effective in removing the fecaloma in half of the children. Administering high doses for a longer period should be tested to provide outpatient disimpaction for severe fecalomas. Rectums remained flaccid after emptying.
dc.languageEnglish
dc.publisherWILEY
dc.titleTreatment of fecal impaction in children using combined polyethylene glycol and sodium picosulphate
dc.typeJournal Article
dc.identifier.doi10.1002/jgh3.12062
melbourne.affiliation.departmentPaediatrics (RCH)
melbourne.affiliation.departmentRural Clinical School
melbourne.affiliation.department
melbourne.source.titleJGH Open
melbourne.source.volume2
melbourne.source.issue4
melbourne.source.pages144-151
dc.rights.licenseCC BY-NC
melbourne.elementsid1359830
melbourne.contributor.authorVidmar, Suzanna
melbourne.contributor.authorCatto-Smith, Anthony
melbourne.contributor.authorHutson, John
melbourne.contributor.authorSouthwell, Bridget
melbourne.contributor.authorForoughi, Siavash
dc.identifier.eissn2397-9070
melbourne.accessrightsOpen Access


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