The goal of a study published in Current Medical Research and Opinion was to estimate the clinical and economic impact of using polyethylene glycol plus electrolytes in an outpatient setting compared to enemas and suppositories and manual evacuation to treat pediatric fecal impaction based on actual clinical practice across England and Wales.

The present study entailed a chart review to extract clinical outcomes and resource use from the case notes of a cohort of children, from 2 to 11 years of age, with fecal impaction who initially received either polyethylene glycol in an outpatient setting or enemas and suppositories or manual evacuation for initial disimpaction.

The findings showed that 97% of the children treated with polyethylene glycol were successfully disimpacted within 5 days, compared to 73% of those who received enemas and suppositories and 89% of those who underwent a manual evacuation. Meanwhile, there were no notable differences in reported adverse events between the different treatment groups; however, vomiting was markedly higher among those who underwent a manual evacuation. Additionally, there were no significant differences in the number of clinician outpatient visits between treatments, while patients who were treated with polyethylene glycol had significantly fewer hospital admissions and occupied fewer bed days than those who underwent the other interventions. Furthermore, it was estimated that using polyethylene glycol plus electrolytes instead of enemas and suppositories and manual evacuation for disimpaction of the whole annual cohort of fecally impacted children aged 2-11 years could potentially reduce annual NHS expenditure on this condition by 59% and the associated annual number of pediatric hospital admissions by 92%.

Therefore, it was inferred that polyethylene glycol plus electrolytes is a clinically effective and cost-effective treatment for the disimpaction of children suffering from fecal impaction compared to enemas and suppositories or a manual evacuation.