Constipation in childhood: a controlled comparison between lactulose and standardized senna

Area of Science:

• Pediatrics
• Gastroenterology
• Pharmacology

Background:

• Chronic constipation is a common pediatric condition requiring effective treatment.
• Laxatives such as lactulose and senna are frequently used for pediatric constipation.
• Understanding the comparative efficacy and tolerability of these treatments is crucial.

Purpose of the Study:

• To compare the efficacy and tolerability of lactulose versus senna in treating chronic constipation in children.
• To evaluate the impact of these treatments on stool consistency and patient-reported side effects.

Main Methods:

• A 3-week crossover trial involving 21 children under 15 with chronic constipation.
• Participants received either lactulose or senna for one week, followed by a week of no treatment, and then the alternative treatment.
• Parental diaries recorded stool characteristics and side effects.

Main Results:

• A significantly greater number of days with normal stools were observed during lactulose treatment compared to senna.
• The frequency and number of reported side effects were significantly higher with senna than with lactulose (p < 0.001).

Conclusions:

• Lactulose is recommended as an effective and well-tolerated treatment for pediatric chronic constipation.
• Lactulose demonstrates superior efficacy and tolerability over senna in this pediatric population.