A PROSPECTIVE RANDOMIZED STUDY WITH MINERAL-OIL AND ORAL LAVAGE SOLUTION FOR TREATMENT OF FECAL IMPACTION IN CHILDREN

Faecal impaction with or without encopresis is a very common problem. We performed a randomized, open-label, prospective study to compare th e efficacy and acceptability of the treatment of faecal impaction usin g either mineral oil or pineapple-flavoured isotonic intestinal lavage solution containing polyethylene glycol-3350 (Colyte). Thirty-six pat ients over 2 years of age were randomized to receive either mineral oi l or flavoured lavage solution. The dose of mineral oil was 2 to 8 tab lespoons twice a day for two days (17 patients-Group I) and of lavage solution was 20 ml/kg/h for 4 hours on two consecutive days (19 patien ts-Group II). The patients were assessed for the presence of abdominal faecal masses, presence and consistency of rectal mass, perineal soil ing before and two days after either of the randomly assigned treatmen t. The patients and parents were asked regarding the compliance with t reatment, side-effects, number of bowel movements after treatment and willingness to try similar treatment if faecal impaction recurred. Pat ients in the lavage group had more frequent bowel movements, and showe d more effective clearance of abdominal and rectal lumps (P < 0.01) at the time of repeat examination at two days. However, they had some vo miting and were less compliant (P < 0.01) when compared to mineral oil patients. We conclude that balanced lavage solution effectively relie ves faecal impaction, however, compliance with its use is poorer than that with mineral oil.