CONSTIPACION EN PEDIATRIA PDF

Use of polyethylene glycol in functional constipation and fecal impaction. Universidad de Valencia. Objective: The objective of this study was to evaluate in an analytical and descriptive manner the evidence published so far on the use of polyethylene glycol PEG , with or without electrolytes, in the management of functional constipation and the treatment of fecal impaction. Results: Fifty-eight publications have been chosen for descriptive analysis; of them, 41 are clinical trials, eight are observational studies and nine are systematic reviews or meta-analysis.

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Use of polyethylene glycol in functional constipation and fecal impaction. Universidad de Valencia. Objective: The objective of this study was to evaluate in an analytical and descriptive manner the evidence published so far on the use of polyethylene glycol PEG , with or without electrolytes, in the management of functional constipation and the treatment of fecal impaction.

Results: Fifty-eight publications have been chosen for descriptive analysis; of them, 41 are clinical trials, eight are observational studies and nine are systematic reviews or meta-analysis. Twelve clinical trials evaluate PEG efficacy versus placebo, eight versus lactulose, six are dose studies, five compare polyethylene glycol with and without electrolytes, two compare its efficacy with respect to milk of magnesia, and the rest of the trials evaluate polyethylene glycol with enemas two , psyllium one , tegaserod one , prucalopride one , paraffin oil one , fiber combinations one and Descurainia sophia one.

Conclusions: Polyethylene glycol with or without electrolytes is more efficacious than placebo for the treatment of functional constipation, either in adults or in pediatric patients, with great safety and tolerability. These preparations constitute the most efficacious osmotic laxatives more than lactulose and are the first-line treatment for functional constipation in the short and long-term. They are as efficacious as enemas in fecal impaction, avoid the need for hospital admission and are well tolerated by patients mainly when administered without electrolytes.

Key words: Functional constipation. Fecal impaction. Polyethylene glycol. Los laxantes son sustancias utilizadas desde tiempos remotos para diferentes usos. Publicaciones en edad adulta Tabla II.

Hay dos ensayos aleatorizados no ciegos que comparan PEG con leche de magnesia 38, Se incluye un ensayo que compara la eficacia de PEG con aceite de parafina 40 y otro con Descurainia sophia L. En , Attar y cols. Posteriormente, en , Bouhnik y cols. Dos estudios analizan la eficacia de las dos presentaciones de PEG. No se obtuvieron diferencias significativas entre ambas preparaciones.

Lee-Robichaud y cols. Revisan diez ensayos cuatro en adultos que incluyen un total de pacientes. Kateralis y cols. Posteriormente, Nurko y cols. Cinco estudios comparan la eficacia, tolerabilidad y efectos secundarios del PEG frente a la lactulosa con resultados dispares.

En , Gremse y cols. En , Voskuijl y cols. Dupont y cols. Candy y cols. En , Wang y cols. En , Treepongkaruna y cols. Hay dos ensayos que comparan diferentes tipos de PEG. No se observan diferencias entre ambos preparados en la eficacia y se detecta una leve hiponatremia en el grupo tratado con PEG sin electrolitos. Ratanamongkol y cols. Nimrauzi y cols. Descurainia sophia L. No observaron ninguna diferencia en cuanto a la frecuencia de las deposiciones ni efectos secundarios al final del estudio entre ambos productos, si bien el PEG fue mejor aceptado.

Los efectos adversos, incluida la diarrea, fueron leves y desaparecieron al disminuir la dosis. Resultados similares fueron obtenidos por Michail y cols. Se concluye que ambas fueron eficaces y seguras en el tratamiento del EF sin diferencias entre ellas. Las conclusiones fueron que el PEG es un laxante que presenta igual efectividad a largo plazo que otros laxantes, como la leche de magnesia o el aceite mineral, y que es superior a la lactulosa.

En , Kuizenga-Wessel y cols. De los 1. En , Youssef y cols. En , Candy y cols. Dos estudios analizan comparativamente con enemas la eficacia de PEG 55, Todos los pacientes se desimpactaron sin ingreso hospitalario. Los autores quieren agradecer al Dr. Bowel disorders. Gastroenterology ; DOI: Andorsky RI, Goldner F.

Colonic lavage solution polyethylene glycol electrolyte lavage solution as a treatment for chronic constipation: A double-blind, placebo-controlled study. Am J Gastroenterol ;85 3 Evaluation and use of polyethylene glycol in constipated patients. GEN ;45 4 Polyethylene glycol for slow transit constipation.

Z Gastroenterol ;33 1 Small volume isosmotic polyethylene glycol electrolyte balanced solution PMF in treatment of chronic nonorganic constipation. Dig Dis Sci ;41 8 Braintree polyethylene glycol PEG laxative for ambulatory and long-term care facility constipation patients: Report of randomized, crossover trials.

Online J Dig Health ; Long term efficacy, safety, and tolerabilitity of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution PMF in the treatment of functional chronic constipation.

Gut ;46 4 A randomized, placebo-controlled, multicenter study of the safety and efficacy of a new polyethylene glycol laxative. Am J Gastroenterol ;95 2 New polyethylene glycol laxative for treatment of constipation in adults: A randomized, double-blind, placebo-controlled study.

South Med J ;94 5 Overnight efficacy of polyethylene glycol laxative. Am J Gastroenterol ;97 7 A randomized, multicenter, placebo-controlled trial of polyethylene glycol laxative for chronic treatment of chronic constipation. Am J Gastroenterol ; 7 Chaussade S, Mini M. Comparison of efficacy and safety of two doses of two different polyethylene glycol-based laxatives in the treatment of constipation.

Aliment Pharmacol Ther ;17 1 Comparison of polyethylene glycol with and without electrolytes in the treatment of constipation in elderly institutionalized patients: A randomized, double-blind, parallel-group study. Drugs Aging ;26 8 A randomized, controlled comparison of low-dose polyethylene glycol plus electrolytes with ispaghula husk in the treatment of adults with chronic functional constipation.

Clin Drug Investig ;24 10 A randomized, multicenter comparison of polyethylene glycol laxative and tegaserod in treatment of patients with chronic constipation. Am J Gastroenterol ; 9 Aliment Pharmacol Ther ;37 9 Highly effective new oral therapy for faecal impaction. Br J Gen Pract ;48 Evaluation of polyethylene glycol plus electrolytes in the treatment of severe constipation and faecal impaction in adults. Curr Med Res Opin ;21 10 Lack of lasting effectiveness of PEG laxative treatment of constipation.

J Clin Gastroenterol ;39 7 An open-label study of chronic polyethylene glycol laxative use in chronic constipation. Aliment Pharmacol Ther ;25 6 Ramkumar D, Rao SS. Efficacy and safety of traditional medical therapies for chronic constipation: Systematic review. Am J Gastroenterol ; 4 Systematic review of stimulant and non-stimulant laxatives for the treatment of functional constipation.

Lactulose versus polyethylene glycol for chronic constipation. Systematic review and meta-analysis: Polyethylene glycol in adults with non-organic constipation. Int J Clin Pract ;64 7 Comparison of the effectiveness of polyethylene glycol with and without electrolytes in constipation: A systematic review and network meta-analysis.

BMC Gastroenterol ; Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.

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