POLYETHYLENE-GLYCOL-4000 FOR SLOW TRANSIT CONSTIPATION

Slow transit constipation is notoriously difficult to treat. We tested whether polyethylene glycole 4000 (PEG) improves slow transit constip ation. Eight female outpatients with symptoms of constipation and a co lonic marker transit of more than 60 h were included (age 46+/-4y, dur ation of complaints 17+/-3y) in a randomised controlled cross-over stu dy. During a 6-week placebo and 6-week PEG-phase (60g PEG/d) the follo wing parameters were measured: 1. subjective well-being with respect t o defeacation on a visual analogue scale (-8 cm very bad, +8 cm very g ood), 2. in the first 5 weeks of each phase, average dose of sodium pi cosulfate (prescribed as only allowed laxans, dose adjusted and protoc olled on a diary by patient) 3. stool frequency, 4. colonic transit of radiopague polythene pellets in the last week of each phase (the use of laxative was strictly prohibited in this last week). Both subjectiv e and objective parameters of colonic function improved significantly. Visual analog scale ratings improved from -4.65, [-8; 0.5] to 4.65, [ -8; 7.5]cm (median, range) (p=0.028), the self-administered dose of so dium picosulfate decreased from 4, [0; 37] to 0, [0; 11] drops per day (p=0.028), stool frequency increased from 3.1, [1; 30] to 11, [2; 33] defaecations per week (p=0.017), and total colonic transit decreased from 91, [67; 116] to 43 h, [17; 76]h (p=0.017). In conclusion, PEG im proves colonic function in patients with slow transit constipation sub jectively and objectively. PEG should be considered as an additional o ption in patients refractory to established forms of treatment.