Overview:
Polyethylene glycol is an osmotic laxative indicated for the cleansing of the bowels and thus is a medication for individuals suffering from constipation. Polyethylene glycol is a white-colored powder that is to be mixed with water before intake of the drug. Polyethylene glycol cannot be eaten without reconstitution with water. Polyethylene glycol has an average molecular weight of 3350; because of this reason, Polyethylene glycol is also called Polyethylene glycol 3350. The molecular weight of Polyethylene glycol is between 90 % to 110 %. The chemical formula of Polyethylene glycol is HO(C2H4O)n, where n is representative of the number of oxyethylene groups. Polyethylene glycol is a free-flowing white powdery substance when it is kept below 55 degrees celsius and is thus easily soluble in water at the same temperature.
Polyethylene glycol or Polyethylene glycol 3350 was first reported in 1859 and was produced due to the chemical interaction between water, ethylene glycol, and ethylene oxide. Polyethylene glycol was first manufactured by Bayer and received approval from the United States Food & Drug Administration (FDA) in February 1999. At that time, it was marketed under the name of MiraLax. Still, today Polyethylene glycol is available under several brand names even though they all have the exact composition of Polyethylene glycol 3350.
How Does Polyethylene Glycol Work?
Being an osmotic agent, Polyethylene glycol retains the water in the stool. Polyethylene glycol works by bringing down and absorbing water from the muscles into the intestines and the bowels—this aids in maintaining a good amount of hydration in the digestive system. The stool produced is softer and is passed quickly out of the body. The softening of the stool increases the frequency of bowel movements, mainly due to the presence of retained water in the stool. The initial bowel movements occur within 24 hours to 72 hours of ingesting Polyethylene glycol, but this time varies from patient to patient.
Uses:
Polyethylene glycol 3350 is a white powder that needs to be mixed with water before ingestion. Polyethylene glycol is a prescription drug that is used as a laxative for the treatment of constipation. In addition, the drug aids in the cleansing of the bowels. Only a healthcare provider gives the prescription. Polyethylene glycol is to be used only for the patient for whom the drug was prescribed and nobody else. Mentioned below are the uses of Polyethylene glycol.
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Occasional constipation.
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Clearing the bowels.
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Irritable bowel syndrome or IBS.
Dosage:
The generally prescribed dosage of Polyethylene glycol is 17 grams of Polyethylene glycol powder which equals a heap of a tablespoon. This is to be mixed with 8 ounces of water or as directed by the healthcare provider. Polyethylene glycol is distributed with a measuring cup or a measuring spoon with an indication line. To begin the bowel movements, Polyethylene glycol can take anywhere between one to four days,
Warning:
Polyethylene glycol was known to have no warning or adverse reactions until 2011. This was when the United States Food and Drug Administration placed an adverse effect of Polyethylene glycol that was reported in 2011 among a number of patients. In addition, Polyethylene glycol was found to produce neuropsychiatric events related to the nervous system, such as tics, tremors, and obsessive-compulsive behavior in children. Henceforth, patients are warned about such neuropsychiatric events, especially in the younger age group.
For Patients:
What Do You Need to Know About Constipation?
Constipation refers to the malfunctioning of the bowel that leads to the passage of stool being difficult or delayed. During constipation, the stool becomes extremely dry and hard in consistency which leads to the added difficulty in the passage of stool. Mentioned below are a few of the signs and symptoms of constipation.
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Bloating.
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Distended abdomen.
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Discomfort in the abdomen.
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Passing stools once in ten days or more.
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Excessive strain during bowel movements.
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Feeling fullness of the abdomen.
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Generalized discomfort.
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Mental frustration.
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Irritable mood swings.
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An increased amount of thirst.
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Cramps near the stomach.
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Nausea.
Constipation is not a disease, but it is a condition that needs to be treated. Fecal matter contains a lot of human waste from various systems of the body. The waste must not remain within the body cavity for a long time and thus needs to be excreted on a regular basis. If the stool is lodged within the rectum and the bowels, the inner lining of the tissue is likely to develop detrimental diseases. Mentioned below are the complications of untreated and long-standing constipation.
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Severe dehydration.
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Piles.
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Hemorrhoids.
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Bowel incontinence.
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Ulcers in the rectum.
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Anal fissure.
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Impaction of fecal matter.
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Distended veins of the rectum.
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Intestinal protrusion from the anus.
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Bleeding from the rectum.
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Stercoral ulcerations or perforations.
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Bowel obstruction.
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Chronic constipation.
Constipation is not caused due to a single reason. There are several etiological factors that lead to the development of constipation, and they range from genetic, environmental, behavioral, habitual, and medical factors. The diet and lifestyle of an individual additionally play a critical role in the development of constipation. Mentioned below are a few of the causes that may be considered the etiological reason behind constipation.
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Known history of irritable bowel syndrome.
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Pelvic floor malfunctioning.
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Hypothyroidism.
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Celiac disease.
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Non-celiac gluten hypersensitivity.
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Cancer of the colon.
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Inflammatory bowel syndrome.
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Intake of opioids.
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Antacid therapy.
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Calcium channel blockers.
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Anticholinergics.
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Restricted diet.
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Weight loss journey.
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Diet low in water and fiber.
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Dehydration.
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Sedentary lifestyle.
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No regular exercise.
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Traveling.
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Excessive dairy consumption.
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Stress.
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Resisting the urge to empty the bowels.
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Senile age group.
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An underlying disease of the digestive system, especially the intestines.
When Should We Use Polyethylene Glycol for Constipation?
Constipation has home remedies as well as drug therapy to be corrected. Polyethylene glycol is to be used when the patient has undergone several kinds of home remedies, but constipation still remains. Mentioned below are a few of the ways constipation can be relieved, but none of them pose a guaranteed treatment like that reported due to Polyethylene glycol. It should be noted that almost all the treatment modalities mentioned below take a long amount of time to be cured, and in the majority of cases, constipation is not fully treated. Polyethylene glycol has been established to treat constipation thoroughly. Polyethylene glycol must be reconstituted with water and taken strictly after it is prescribed by the respective healthcare provider.
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Increasing the amount of water intake.
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Drinking honey and lukewarm water on an empty stomach.
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Running.
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Increased physical activeness.
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Increasing the amount of fiber in one’s diet.
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Intake of caffeine and related beverages for a short amount of time.
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Massage of the abdomen.
How Effective Is Polyethylene Glycol for Constipation?
Polyethylene glycol will begin the bowel movements anywhere between one to four days, depending on different individuals. Polyethylene glycol has been studied to be highly effective in bowel clearance by softening the stool due to water retention.
Things to Inform Your Respective Healthcare Provider Before Being Prescribed Polyethylene Glycol.
Polyethylene glycol is a drug that helps in bowel clearing and increases bowel movements that lead to the correction of constipation. This occurs by pulling the water out of the muscles and storing the water within the rectum. Due to this reason, the stool becomes soft, and the removal of the stool from the anus becomes easier. The entire bowel can be cleared with Polyethylene glycol after several bowel movements. Before going ahead with the treatment of Polyethylene glycol, the patient is requested to mention the presence of certain medical aspects to their respective healthcare provider. Mentioned below are the things to be informed to the healthcare expert before they prescribe and suggest treatment with Polyethylene glycol.
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Known allergy to Polyethylene glycol.
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History of severe dehydration.
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Recent episodes of muscle cramps.
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Recent hospitalization.
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Diagnosed with bowel obstruction.
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Epileptic patients.
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Patients undergoing psychotherapy.
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Patients suffering from kidney disorders.
How to Use Polyethylene Glycol?
Polyethylene glycol is a laxative that helps in clearing the bowel and thus aids in constipation. Polyethylene glycol is a white-colored powder that is to be mixed with water before intake of the drug. Polyethylene glycol cannot be eaten without reconstitution with water. The generally prescribed dosage of Polyethylene glycol is 17 grams of Polyethylene glycol powder which equals a heap of a tablespoon. This is to be mixed with 8 ounces of water or as directed by the healthcare provider. This is to be taken once a day for as long as it has been prescribed. Polyethylene glycol is distributed with a measuring cup or a measuring spoon with an indication line. To begin the bowel movements, Polyethylene glycol can take anywhere between one to four days. Only a healthcare provider gives the prescription. Polyethylene glycol is to be used only for the patient for whom the drug was prescribed and nobody else.
Keep Track of the Changes After Ingesting Polyethylene Glycol.
After ingesting and beginning the treatment with Polyethylene glycol, there are some clinical manifestations that should be noticed in the patient. Such changes must be observed keenly, and the patient should be monitored because they may require the patient to consult their respective health care providers for the same.
Mentioned below are the changes that may develop after beginning the treatment with Polyethylene glycol.
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Nausea.
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Stomach fullness.
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Bloating.
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Lethargy.
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Muscle cramps.
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Diarrhea.
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Flatulence.
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Vomiting.
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Abdominal distension.
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Skin rashes.
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Mania.
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Aggression.
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Mood swings.
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Rage and anger.
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Obsessive-compulsive behavior.
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Tremors.
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Tics.
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Seizure episodes.
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Neuropsychiatric events.
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Increased urinary output.
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Difficulty in vision.
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Headache.
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Lightheadedness.
Avoid Self-Medication:
Polyethylene glycol is an osmotic laxative that is indicated for the cleansing of the bowels and thus is a medication for individuals suffering from constipation. Only a healthcare provider gives the prescription. Polyethylene glycol is to be used only for the patient for whom the drug was prescribed and nobody else. Licensed pharmacists, nurses, or any other medical representative must not prescribe Polyethylene glycol. An experienced healthcare professional, after diagnosing the condition and understanding the medical history, drug history, and personal history of the patient, makes a decision to prescribe Polyethylene glycol. Thus, self-medication of Polyethylene glycol must be strictly avoided.
What Should Be Done in Case of an Overdosage of Polyethylene Glycol?
An overdose of Polyethylene glycol is rare. Diarrhea that is occurring multiple times is one of the indications that there may be a susceptive overdosage of Polyethylene glycol. In such cases, the administration of the drug must be abruptly stopped, and the patient should be given excessive amounts of fluids.
For Doctors:
Indications:
Polyethylene glycol is an osmotic laxative that is indicated for the cleansing of the bowels and thus is a medication for individuals suffering from constipation. Mentioned below are several indications of Polyethylene glycol.
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Occasional constipation.
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Clearing the bowels.
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Irritable bowel syndrome or IBS.
Pharmacology:
Mechanism of Action:
Being an osmotic agent, Polyethylene glycol retains the water in the stool. Polyethylene glycol works by bringing down and absorbing water from the muscles into the intestines and the bowels—this aids in maintaining a good amount of hydration in the digestive system. The stool produced is softer and is passed quickly out of the body. The softening of the stool increases the frequency of bowel movements, mainly due to the presence of retained water in the stool. The initial bowel movements occur within 24 hours to 72 hours of ingesting Polyethylene glycol, but this time varies from patient to patient. Polyethylene glycol has been studied to be highly effective in bowel clearance by softening the stool due to water retention.
Ingredients:
Active Ingredient:
Polyethylene glycol 3350.
Absorption:
Polyethylene glycol is readily absorbed once it is mixed with water. The exact ratio of powder and liquid is mentioned in the packaging, but it can be altered as prescribed by the health care provider. There is no active absorption of Polyethylene glycol, nor is there any secretion of glucose.
Distribution:
The distribution of Polyethylene glycol is still unclear and is being studied.
Metabolism:
The metabolism of Polyethylene glycol is still unclear and is being studied.
Elimination:
Total recovery of Polyethylene glycol has been established in patients who were not suffering from constipation. In vitro studies have shown that Polyethylene glycol did not get fermented into hydrogen and methane gas.
Warning and Precautions:
Polyethylene glycol was known to have no warning or adverse reactions until 2011. This was when the United States Food and Drug Administration placed an adverse effect of Polyethylene glycol that was reported in 2011 among a number of patients. In addition, Polyethylene glycol was found to produce neuropsychiatric events related to the nervous system, such as tics, tremors, and obsessive-compulsive behavior in children. Henceforth, patients are warned about such neuropsychiatric events, especially in the younger age group.
Dosage and Administration:
Polyethylene glycol is a laxative that helps in clearing the bowel and thus aids in constipation. Polyethylene glycol is a white-colored powder that is to be mixed with water before intake of the drug. Polyethylene glycol cannot be eaten without reconstitution with water. The generally prescribed dosage of Polyethylene glycol is 17 grams of Polyethylene glycol powder which equals a heap of a tablespoon. This is to be mixed with 8 ounces of water or as directed by the healthcare provider. This is to be taken once a day for as long as it has been prescribed. A maximum of fourteen days is the suggested dosage. Polyethylene glycol is distributed with a measuring cup or a measuring spoon with an indication line. To begin the bowel movements, Polyethylene glycol can take anywhere between one to four days. Only a healthcare provider gives the prescription. Polyethylene glycol is to be used only for the patient for whom the drug was prescribed and nobody else.
Contraindications:
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Known allergy to Polyethylene glycol.
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Presence of neuropsychiatric disorder.
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History of severe dehydration.
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Recent episodes of muscle cramps.
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Recent hospitalization.
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Anemia.
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Diagnosed with bowel obstruction.
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Epileptic patients.
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Patients undergoing psychotherapy.
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Patients suffering from kidney disorders.
Results from Clinical Trials:
Patients who have less than three bowel movements per day participated in a randomized clinical trial. They were given 17 grams of Polyethylene glycol for fourteen days. There was the presence of an increased bowel movement in these patients during the initial seven days of treatment with Polyethylene glycol. The changes in the bowel movements were drastically increased during the second week of therapy with Polyethylene glycol.
Drug Interactions:
There has not been any specific drug interaction with Polyethylene glycol and other drugs.
Other Specifications:
Polyethylene Glycol During Pregnancy:
There has not been any significant study done with Polyethylene glycol and pregnant lab rats. In addition to this, fetal harm or abnormal development of the fetus due to the intake and administration of pPlyethylene glycol remains unknown. There is no established result of any alterations in the reproductive capacity after intake of Polyethylene glycol. Thus, the healthcare provider must make a decision to prescribe Polyethylene glycol to a pregnant patient only after weighing down the necessity and severity of the condition.
Polyethylene Glycol in Pediatric Patients:
The safety and effectiveness of Polyethylene glycol in children have not been established.
Polyethylene Glycol in Geriatric Patients:
The safety and effectiveness of Polyethylene glycol in geriatric patients have not been established. It has been reported that when senile patients began therapy with Polyethylene glycol, the rate of loose stools was increased, and they suffered from diarrhea. In case patients from the geriatric age group develop nausea and diarrhea, Polyethylene glycol must be discontinued.
Carcinogenesis, Mutagenesis, and Impairment of Fertility:
There has not been any study done on lab rats to study the carcinogenic effects, mutagenic alterations, and the presence of any kind of fertility impairment after the intake of Polyethylene glycol.
Adverse Effects:
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Acute injury to the kidney.
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Oxalate nephropathy.
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End-stage renal disease or ESRD.
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Nausea.
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Stomach fullness.
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Bloating.
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Lethargy.
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Muscle cramps.
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Diarrhea.
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Flatulence.
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Vomiting.
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Abdominal distension.
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Skin rashes.
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Hives.
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Anxiety.
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Mania.
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Aggression.
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Mood swings.
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Rage and anger.
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Obsessive-compulsive behavior.
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Tremors.
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Tics.
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Seizure episodes.
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Neuropsychiatric events.
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Increased urinary output.
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Difficulty in vision.
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Headache.
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Lightheadedness.
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Hepatic impairment.
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Paranoia.
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Fear.
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Development of certain kinds of phobias.
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Acidic blood.
Overdosage:
As of today, there have not been any reports of overdosage of Polyethylene glycol. Diarrhea has been one of the most common adverse effects of this drug. In case there is an increase in the episodes of loose stools and nausea, Polyethylene glycol must be immediately stopped, and the patients must be given an increased amount of water.
