A Retrospective Study Comparing Polyethylene Glycol-Electrolyte Solution With Magnesium Citrate for Treatment of Fecal Disimpaction.
Level 3 - non-randomized controlled study
Retrospective non-randomized comparative cohort study
PubMed 29596128 · doi:10.1097/SGA.0000000000000315
What was done
A retrospective chart review of 103 children aged 1–18 years (mean age 8 years; 45 female, 59 male) evaluated the efficiency of two fecal disimpaction regimens: nasogastric polyethylene glycol-electrolyte solution (PEG-ELS, n = 46) versus oral magnesium citrate (n = 57). The primary outcome measured was time from cleanout start to abdominal radiograph confirmation of successful stool clearance, along with adjunct enema use and adverse events.
What was found
Average cleanout time was 5 hours 15 minutes (range: 3 hours 30 minutes to 7 hours) for nasogastric PEG-ELS and 5 hours 30 minutes (range: 2 to 8 hours) for oral magnesium citrate. Failure to clear stool on a second radiograph occurred in 15% (7/46) of the PEG-ELS group and 10% (6/57) of the magnesium citrate group. Children in the PEG-ELS group required an average of 2.5 enemas compared with 3.0 enemas in the magnesium citrate group. Vomiting occurred with both therapies, and 12% (7/57) of children were unable to finish the full magnesium citrate dose.
Why it matters
Oral magnesium citrate achieves comparable disimpaction timing and stool clearance to nasogastric PEG-ELS while avoiding invasive nasogastric tube placement and higher medication costs, provided the child can tolerate oral intake.
Limits
Retrospective non-randomized design without statistical hypothesis testing or control for treatment selection bias. Both cohorts received variable numbers of concurrent enemas, palatability issues caused incomplete ingestion in 12% of oral magnesium citrate recipients, and long-term outcomes were not measured.
Cited by
- supports Magnesium citrate has an osmotic laxative effect and is used to relieve constipation.