Shahnaz Sultan, MD, MHSc; Baharak Moshiree, MD
What is the relative effectiveness of polyethylene glycol (PEG) and lactulose for treatment of chronic constipation and fecal impaction?
Included studies compared PEG with lactulose in children or adults with chronic constipation (Rome III criteria) or fecal impaction. Outcomes included change in stool frequency, form of stool (Bristol Stool Score), use of additional products, and relief of abdominal pain.
Medline, EMBASE/Excerpta Medica, CINAHL, and the Cochrane Central Register of Controlled Trials were searched to January 2008 for randomized controlled trials (RCTs). Bibliographies of retrieved studies and relevant conference proceedings were searched, and experts and pharmaceutical companies were contacted. 10 RCTs (n = 868, age range 3 mo to 70 y) met the selection criteria; 3 RCTs met ≥ 4 of 6 methodological criteria.
PEG was more effective than lactulose for stool frequency, form of stool, and need for additional products (Table); PEG was more effective for relief of abdominal pain in children but did not differ from lactulose in adults (Table).
Polyethylene glycol is more effective than lactulose for treatment of chronic constipation in children and adults.
Polyethylene glycol (PEG) vs lactulose for chronic constipation or fecal impaction in adults and children*
*Abbreviations defined in Glossary. RBI, RRR, NNT, and CI calculated from data in article using a fixed-effect model unless otherwise indicated.
‡Based on a random-effects model.
§Higher scores = softer stools.
Sultan S, Moshiree B. Review: Polyethylene glycol is more effective than lactulose for chronic constipation in children and adults. Ann Intern Med. ;153:JC6–5. doi: 10.7326/0003-4819-153-12-201012210-02005
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Published: Ann Intern Med. 2010;153(12):JC6-5.
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