Background: Pediatric functional constipation is a common issue that imposes significant personal and societal burdens. While managing painful defecation is essential in controlling the vicious cycle of stool withholding and altered rectal physiology, current approaches have addressed stool consistency rather than focusing on this critical outcome.
Aim: We aim to assess if adding paraffin to polyethylene glycol (PEG) affects painful defecation and other constipation outcomes in children with chronic functional constipation. Paraffin, with its lubricating mechanism, is hypothesized to improve stool passage and reduce pain during defecation.
Methods: We randomized 148 children with chronic functional constipation to receive either PEG plus paraffin or PEG alone for three months. We assessed painful defecation, number of defecations per week, and stool consistency as primary outcomes at baseline and after the intervention. Secondary outcomes included nausea and vomiting, diarrhea, abdominal pain, and incontinence. We used the t-test, one-way analysis of variance (ANOVA), and repeated measures analysis to compare means in our data, and we used the chi-squared test to compare categorical data between groups. We utilized IBM SPSS Statistics 21 software for data analysis, and a p-value of 0.05 or lower was considered statistically significant. We also calculated effect sizes as mean difference and numbers needed to treat (NNT) in addition to their 95% confidence interval using MedCalc.
Results: Our study indicates that adding paraffin to PEG significantly improves painful defecation in children with chronic functional constipation. In contrast, it did not considerably impact stool consistency or the number of defecations.
Conclusion: Our findings suggest that paraffin can be a valuable adjunct to PEG in managing painful defecation, a crucial aspect of constipation treatment.