American Society of Hirudotherapy

Sennosides vs magnesium hydroxide vs polyethylene glycol as a treatment for constipation in anorectal malformation: a randomized crossover trial

Randomized controlled trial published in Pediatric surgery international (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Randomized controlled trialClinical TrialsNate-Anong B et al. · Pediatric surgery international, 2025

Abstract

PURPOSE: To compare the efficacy and user preference of Sennosides, magnesium hydroxide (Mg(OH)2), and polyethylene glycol (PEG) in treating constipation in ARM patients. METHODS: A randomized crossover trial was conducted from January 2018 to December 2019. Fifteen patients with surgically corrected ARM and diagnosed constipation were enrolled. Each patient received all three laxatives in a random order for 21-day periods, separated by washout periods. The primary outcome was post-treatment fecal loading assessed by Leech score on abdominal radiography. Secondary outcomes included the rate of clean fecal loading (Leech score ≤ 6) and user preference scores. RESULTS: The mean post-treatment Leech scores were 6.67 ± 2.09 for Sennosides, 6.80 ± 2.37 for Mg(OH)2, and 5.80 ± 2.04 for PEG(p = 0.841). Clean fecal loading was achieved in 40% of cases with Sennosides, 46.67% with Mg(OH)2, and 60% with PEG(p = 0.655). User preference scores favored Sennosides (7.00 ± 2.36) over Mg(OH)2 (6.33 ± 2.94) and PEG (5.06 ± 2.28) with p = 0.582. No significant differences in treatment, period, or sequence effects were found, with the exception of a decrease in preference for Mg(OH)2 compared with Sennosides in the third treatment period (p = 0.045). CONCLUSION: While PEG showed a trend towards better fecal clearance and Sennosides was preferred by users, no statistically significant differences in efficacy or user preference were found among the three laxatives.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleRandomized Controlled TrialComparative Study
Indexed MeSH termsHumansCross-Over StudiesConstipationPolyethylene GlycolsMaleFemaleLaxativesMagnesium HydroxideAnorectal MalformationsSennosidesTreatment OutcomeChild

Summary

To compare the efficacy and user preference of Sennosides, magnesium hydroxide (Mg(OH)), and polyethylene glycol (PEG) in treating constipation in ARM patients.

Why This Matters for Hirudotherapy

This randomized crossover trial compared sennosides, magnesium hydroxide, and polyethylene glycol for constipation in 15 patients with surgically corrected anorectal malformations, using the 'Leech score' on abdominal radiography as the primary outcome measure. No statistically significant differences in efficacy or preference were found among the three laxatives, though PEG showed a trend toward better fecal clearance and sennosides were preferred by users. The abstract does not explain the origin of the 'Leech score' term or connect it to leeches or hirudotherapy in any way. This article has no relevance to ASH's domain.

Citation

Sennosides vs magnesium hydroxide vs polyethylene glycol as a treatment for constipation in anorectal malformation: a randomized crossover trial

Nate-Anong B et al. · Pediatric surgery international, 2025

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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