Comparison of effectiveness between polyethylene glycol 4000 and lactulose in the treatment of pediatric functional constipation

Abstract

Aim: Functional constipation is a common illness in children that requires close follow-up and long-term treatment. This study aims to compare the effectiveness of lactulose and PEG 4000 in the treatment of pediatric functional constipation. Methods: One hundred and twenty-three patients included in this cross-sectional study were all diagnosed with functional constipation according to Rome IV criteria. The ages of the patients, who were all referred to the pediatric gastroenterology outpatient clinic between November 2017 and May 2018, ranged between 8 months and 4 years. Patients with accompanying organic diseases were excluded from the study. Children treated with Lactulose were included in the LAC group and those treated with PEG 4000 were included in the PEG group. The number of bowel movements, Bristol Stool Form Scale (BSFS), pain during bowel movements, formation of anal fissures and fecal impaction at diagnosis and during follow-up were noted from the patient files. A comparison was then made in 1st and 3rd months between the diagnostic findings and follow-up of patients in both groups. Results: There were no age or gender-based differences between the two groups. Sixty-two (50%) patients received lactulose and the remaining 61 patients (50%) received PEG 4000 as treatment. At the end of the third month, patients had improved significantly more in the PEG group in terms of number of daily bowel movements, the presence of pain during bowel movement and median BSFS score (P<0.001). Conclusion: While lactulose and PEG 4000 are both effective in the treatment of functional constipation in children, PEG 4000 is a more effective and successful treatment option compared to lactulose without increased side effects.