Hypertonic liquids: a potential method for reducing super absorbent polymer bead associated bowel obstructions in children.

PURPOSE

Super absorbent polymer (SAP) beads grow in the presence of liquids, leading to a risk of small bowel obstruction (SBO) following ingestion, but there is little data to guide management in children following SAP bead ingestion. We hypothesize that certain hypertonic liquids could limit the growth of the beads and shrink them, potentially serving as a treatment to prevent SBO.

METHODS

Specific hypertonic liquids were identified a priori to be studied including 100% fruit juices, mineral oil, 50% and 100% Gastrografin, Pedialyte, Cola, polyethylene glycol, and Milk of Magnesia. Simulated intestinal fluid was used as a control. SAP bead growth and shrinkage (after 24 h of pre-hydration) were compared using linear regression with log transformation.

RESULTS

Mineral oil, Gastrografin, and 100% fruit juices were found to be the most effective at preventing bead growth as compared to intestinal fluid for both small and large beads (p < 0.001). 100% fruit juices were found to be the most effective at shrinking pre-hydrated beads (p < 0.001).

CONCLUSION

Gastrografin and 100% fruit juices have the potential to limit the growth of and shrink SAP beads following ingestion. Protocols using these liquids following SAP bead ingestion may be beneficial in preventing SBO-related surgery.