Objective: To investigate the efficacy and tolerability of polyethylene glycol/ electrolyte solution (Movicol®, Norgine Ltd) therapy in patients with faecal impaction and severe constipation.
Patients: 16 inpatients (aged 26 to 87 years) and 14 outpatients (aged 17 to 61 years) with a history of chronic constipation, who had not had a bowel motion for 5 or more days and had faecal loading confirmed by clinical examination, were enrolled in this open study in a large general, teaching hospital in Edinburgh, Scotland. Patients who were completely bedridden, or had suspected intestinal obstruction or severe inflammatory bowel disease were excluded.
Intervention: Each daily treatment consisted of 1 litre of Movicol, administered as two 500ml portions to be taken within 4 to 6 hours.
Outcome Measures and Results: Relief of impaction was strictly defined as passage of a large or moderate volume of stool together with disappearance of previously palpable faecal masses in the abdomen and/or rectum. Complete resolution of constipation or impaction was obtained in 13 patients after 1 day, 11 more after 2 days and one more after 3 days. All other patients were significantly improved. The only symptom significantly associated with the treatment was abdominal rumbling, evidence of the action of the drug in stimulating colonic motility.
Conclusion: Movicol, given as a treatment dose equivalent to eight sachets (1 litre) daily for up to 3 days, was a highly effective and acceptable oral therapy for faecal impaction.