Abstract:

Objective To assess the efficacy and safety of polyethylene glycol 4000 (PEG4000) in constipated children younger than 8 years.Methods The randomized controlled trials of PEG4000 compared with other active comparator in children younger than 8 years with primary chronic constipation were conducted by an electronic search of Cochrane library, PubMed, EMBASE, ISI Web of Science, VIP, and CNKI, with the retrieval time from January 1981 to April 2016. Results Four qualifying studies involving 344 children were identified. Two were comparisons of PEG4000 with lactulose, one with milk of magnesia and one with PEG-electrolyte(PEG-EL). Study duration ranged from 2 weeks to 12 weeks. Four studies described the generation of random sequence, the allocation concealment and reported the subjects lost to follow-up, 3/4 articles used double-blind method. ①There was no severe adverse reaction observed in four studies. The rate of at least one blood biochemical indexes outside normal of PEG4000 was similar between after and before treatment(35/39 vs 31/39). The incidence of diarrhea was lower in PEG4000 group (2/46 vs 12/43) than in milk of magnesia group; the incidence of nausea was lower in PEG4000 group compared to PEG-EL group (1/49 vs 9/42). ②The stool frenqency was similar in PEG4000 and lactulose groups(8.5 vs 11.5 per week), after four weeks follow up, PEG4000 group had great increase in stool frenqency than PEG-EL group［(9.2 ± 3.2) vs (7.8 ±2.4) times，P=0.025］ and PEG4000 group had significantly higher improvement compared with the patients in the milk of magnesia group (42/46 vs 28/43，P=0.003).Conclusion Limited scientific evidence demonstrated that for children younger than 8 years , PEG4000 use was more effective and tolerated than other active comparators.