Open AccessPEG 3350 Versus Lactulose for Treatment of Functional Constipation in Children
Author(s) -
Jarzebicka Dorota,
SieczkowskaGolub Joanna,
Kierkus Jaroslaw,
Czubkowski Piotr,
KowalczukKryston Monika,
Pelc Maciej,
Lebensztejn Dariusz,
Korczowski Bartosz,
Socha Piotr,
Oracz Grzegorz
Publication year - 2019
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000002192
Subject(s) - lactulose , medicine , constipation , functional constipation , defecation , bloating , peg ratio , randomized controlled trial , randomization , gastroenterology , abdominal pain , adverse effect , surgery , finance , economics
ABSTRACT Objectives: The aim of this study was to compare the clinical efficacy and tolerance of polyethylene glycol 3350 (PEG) and lactulose for the treatment of functional constipation in infants and children. Methods: This randomized, multicenter study covered 12 weeks of treatment and 4 weeks of follow‐up of patients with functional constipation. Patients were randomized (central randomization) to receive either PEG or lactulose. The primary end points were the number of defecations per week after 12 weeks of treatment and improvement in stool consistency of at least 2 points in the Bristol scale. The secondary end point was the presence of adverse events. Bowel movements ≥3 per week and stool consistency ≥2 (Bristol scale) were considered as successful treatment. Results: We enrolled 102 patients (M 57, F 45) aged 3.62 ± 1.42 years and 88 completed the study. At week 12, good clinical outcome was achieved in 98% (PEG) and 90% (lactulose). The PEG group had more defecations per week compared with the lactulose group (7.9 ± 0.6 vs 5.7 ± 0.5, P = 0.008) and both groups had similar frequency of defecation with pain (5% vs 5%, P = 0.9), stool retention (7% vs 10%, P = 057), large volume of stools (30% vs 31%, P = 0.9) and hard stools (7% vs 13%, P = 0.58). There were more patients with side effects in the lactulose group (15 vs 23, P = 0.02), mostly bloating and abdominal pain. Conclusions: PEG 3350 is more effective and causes fewer side effects than lactulose in the treatment of constipation in infants and children.