Philichi Lisa, Yuwono Melawati
Lisa Philichi, MN, ARNP, is Pediatric Nurse Practitioner, Pediatric Gastroenterology Clinic, Mary Bridge Children's Hospital and Health Center, Tacoma, Washington. Melawati Yuwono, MD, is Pediatric Gastroenterologist, Pediatric Gastroenterology Clinic, Mary Bridge Children's Hospital and Health Center, Tacoma, Washington.
Gastroenterol Nurs. 2018 Mar/Apr;41(2):141-144. doi: 10.1097/SGA.0000000000000315.
Fecal disimpaction in the hospital setting may be necessary for a constipated child's condition to improve. This study evaluated the efficiency of 2 disimpaction therapies: nasogastric GoLYTELY (polyethylene glycol-electrolyte solution) compared with oral magnesium citrate. Retrospective chart review of 103 children was conducted to determine the time from the start of the clinic cleanout until abdominal radiograph verification of successful stool evacuation. The children were in an age range of 1-18 years, with average age of 8 years. Forty-five were female and 59 were male. Forty-six (45%) children received nasogastric polyethylene glycol-electrolyte and 57 (55%) drank magnesium citrate. The children receiving nasogastric polyethylene glycol-electrolyte on average required 2.5 enemas, and the children receiving magnesium citrate required 3.0 enemas. The average time for a nasogastric polyethylene glycol-electrolyte cleanout was 5 hours 15 minutes (range: 3 hours 30 minutes to 7 hours) and 5 hours 30 minutes for magnesium citrate cleanout (range: 2 to 8 hours). Seven (15%) children who received nasogastric polyethylene glycol-electrolyte and 6 (10%) of those who drank magnesium citrate did not achieve clearance of stool on the second radiograph. Vomiting was an adverse effect of both medications, and 7 (12%) children were unable to drink the entire magnesium citrate dose. Both methods of disimpaction take the same amount of time. Magnesium citrate can be difficult to drink; however, it is less invasive and less costly than nasogastric polyethylene glycol-electrolyte.
