Which is better for childhood constipation, polyethylene glycol 3350 (PEG) or fiber? A recent study weighs in (J Pediatr 2012; 161: 710-15).
This randomized, prospective, open-label study compared PEG (with electrolytes) to a fiber supplement (acacia fiber, psyllium fiber, and fructose [AFPFF]) in 100 children with chronic functional constipation (Rome III criteria). Mean age was 6.5 years. Study design allowed for dosage adjustment. Initial PEG dosing was 0.5 g/kg but could be increased to 1 g/kg. AFPFF was dosed at 16.8 g daily but could be increased to 22.4 g. Primary outcome was ≥3 bowel movements per week and improved stool consistency (≥2 on Bristol stool scale).
- Compliance was better with PEG than AFPFF: 96% for 72%.
- After 8 weeks, improvement noted in 83% of PEG patients compared to 78% of AFPFF (P=0.788). At this time point, PEG were having ~5.8 stools/week vs. 5.6 for AFPFF. Mean Bristol scores were 3.7 and 3.5 respectively.
- Conclusion: similar efficacy but PEG had better acceptance. No mention of relative costs of these agents is noted.
Diagnosis and management of idiopathic childhood constipation – BMJ NICE (Nat’L institute for Health and Clinical Excellence) recommendations 2010
Also, a recent previous post (ACE report -10 year effectiveness | gutsandgrowth) has links to multiple related blog entries.