Abstract
To the Editor: I appreciated Dr Kaur's Concise Review for Clinicians1Kaur JS Palliative care and hospice programs.Mavo Clin Proc. 2000; 75: 181-184PubMed Scopus (11) Google Scholar on palliative care in hospice programs. In reference to Table 1 of this review, I would like to mention an article by Lederle et al2Lederle FA Busch DL Mattox KM West Ml Askc DM Cost-effective ireatmenl of constipation in the elderly: a randomized double-blind comparison of sorbitol and lactulosc.Am J Med. 1990; 80: 597-601Abstract Full Text PDF Scopus (139) Google Scholar demonstrating that sorbitol is therapeutically equivalent to lactulose. Because sorbitol costs much less than lactulose, it should be the preferred agent. Lactulose vs Sorbitol for Treatment of Obstipation in Hospice Programs: In ResponseMayo Clinic ProceedingsVol. 75Issue 5PreviewDr Weed raises a good point. He is correct that both sorbitol and lactulose are osmotic laxatives and are therapeutically equivalent if constipation is the only indication for their use. The study he cites by Lederle et al1 was done in an elderly ambulatory male population. Patients with metastatic cancer and those receiving narcotics were excluded from eligibility. Full-Text PDF
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