Polyethylene Glycol versus Lactulose in Chronic Pediatric Constipation

Abstract

Introduction: Constipation is one of the most prevalent causes of abdominal pain in pediatrics, with no underlying pathology. It is defined as functional constipation in 95% of cases evaluated. This study was designed to compare the therapeutic effect of polyethylene glycol (PEG) and lactulose in treating chronic functional constipation in children.

Materials and Methods: In this randomized, double blind clinical trial, patients were classified into two groups: lactulose (n=65) and PEG (n=63). During an eight week period, patients were either treated with an average of 3.5 g/day (PEG) or 7 g/day (lactulose). Successful treatment was defined as defecation (painless and soft, or normal) three times or more per week. Analysis was performed by calculation and comparison of the success rate in both groups, followed by reporting the relative risk and number needed to treat (NNT).

Results: Response to treatment in the second week was significantly higher in the PEG group when compared with the lactulose group (P‹0.0001). There was a significant difference in the response rate between both groups in the 4th and 6th weeks (P‹0.0001). In the 8th week all patients in the PEG group were treated successfully, whereas there were five (7.7%) cases who did not respond in the lactulose group.

Conclusion: These results have shown that a four week treatment period with PEG (3 g/day) lead to a response rate of 87% in children, in comparison with lactulose (7 g/day) which needed at least eight weeks of treatment.