Polyethylene Glycol 4000 for Fecal Disimpaction in Cerebral Palsy Children

Objectives This study evaluated the efficacy of Polyethylene glycol 4000 for fecal disimpaction in children with cerebral palsy. Materials & Methods A randomized control trial study was conducted on children with cerebral palsy between February – March 2017 in the pediatric neurology outpatient clinic Dr. Soetomo Hospital. Children aged 2-16 years with fecal impaction randomly assigned into polyethylene glycol 4000 (PEG 4000) and saline enema group. Polyethylene glycol 4000 was given at a dosage of 0.7 g/kg and enema using normal saline 15ml/kg twelve hourly. Constipation was diagnosed using ROME IV criteria, and abdominal palpation identified fecal impaction. Efficacy was evaluated by clinical observation and adverse symptom monitoring. Data were analyzed by statistical software using an independent t-test (p<0,05). Results Thirty-two children were randomized into the study. Muscle relaxant was discovered in 17/32 patients. Sex, age, and body weight were not statistically different between groups. The resolution of fecal impaction was significantly different between PEG 4000 and saline enema (21.69 hours and 39 hours respectively; p=0.001). Application of muscle relaxant and severity of the disease did not involve treatment efficacy. There was no adverse symptom reported during treatment. Conclusion Polyethylene glycol 4000 results in fecal disimpaction faster than enema in constipated children with cerebral palsy.