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

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