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Original Article

Lactulose versus polyethylene glycol for disimpaction therapy in constipated children, a randomized controlled study

Mohammad Salem Shatnawi, Mohammad Mu azi Alrwala, Abdulla Majed Ghanma, Mohammad Lutfi Alquraan, Ehab Nequla Zreiqat, Manar Mohammad Alzoubi.

Background: Fecal disimpaction is very important for successful management of constipation in children. Lactulose is cheap and wide available medicine in compare to other polyethylene glycol preparations. From our experience lactulose is effective and safe medicine for both disimpaction and maintenance therapy in constipated children.
Purpose: To evaluate the safety and efficacy of lactulose in fecal impaction management in children with constipation.
Methods: A prospective controlled trial conducted in children with functional constipation who presented with fecal impaction to Queen Rania Hospital for Children from 15 April 2018 until 15 October 2018. Two randomized matched groups; group A included 33 constipated children treated for disimpaction with higher dose lactulose (10gm/15 ml) 4-6 ml/kg/day (max. 120 ml/day), and group B included 32 children treated for disimpaction with macrogol (polyethylene glycol 4000) 1-1.5 gm/kg (max. 30 grams/day). Both groups received treatment until resolution or up to 6 days. Patients were followed over one week and success of disimpaction were observed, moreover, any adverse events were recorded.
Results: All patients in both groups achieved successful disimpaction by seventh day of therapy, group B showed significant faster response. Both therapies were tolerated and no significant adverse events were reported.
Conclusion: Both agents were safe, effective and well tolerated. lactulose may be a good alternative to polyethylene glycol in the treatment of fecal impaction in constipated children.

Key words: Lactulose; Disimpaction; Constipation; Children

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