Outcome of Various Treatments for Functional Constipation in Children at a Tertiary Care Hospital: A Randomized Clinical Trial

Abstract

Objective: To compare the efficacy of saline enema, polyethylene glycol (PEG), and their combination in children with functional constipation over an eight-week period.

Study design: Randomized clinical trial

Place and duration: Department of Pediatric Surgery Unit II, The Children’s Hospital Lahore, from October 2023 to July 2024.

Material and Methods: Ninety children diagnosed with functional constipation were randomly assigned to one of three groups: saline enema (Group 1), PEG (Group 2), and combined therapy (Group 3). Evaluations were conducted at baseline, and at the 2nd, 4th, and 8th weeks. Outcome measures included pain during defecation, number of bowel movements, fecal soiling, stool consistency and complications. Data were analyzed using SPSS version 25.

Results: Significant improvement in functional constipation were observed in the PEG and combined therapy groups compared to the saline enema group. Pain during defecation was eliminated in 100% of patients in the PEG and combined groups, whereas 33.3% of patients in the saline enema group continued to experience pain. Number of bowel movements increased notably in the PEG and combined groups, with most patients achieving 4 to 7 bowel movements per week. Fecal soiling was entirely resolved in the PEG and combined groups but persisted in 36.7% of the saline enema group. Stool consistency improved in the PEG and combined groups, with most patients achieving normal stool form (Bristol Stool Chart scores of 3 or 4).

Conclusion: PEG as sole or in combination with saline enema significantly more effective than saline enema in managing pediatric functional constipation.