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PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial.
Gut. 2004 Nov; 53(11):1590-4.Gut

Abstract

BACKGROUND

Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative.

AIMS

To compare PEG 3350 (Transipeg: polyethylene glycol with electrolytes) with lactulose in paediatric constipation and evaluate clinical efficacy/side effects.

PATIENTS

One hundred patients (aged 6 months-15 years) with paediatric constipation were included in an eight week double blinded, randomised, controlled trial.

METHODS

After faecal disimpaction, patients <6 years of age received PEG 3350 (2.95 g/sachet) or lactulose (6 g/sachet) while children > or =6 years started with 2 sachets/day. Primary outcome measures were: defecation and encopresis frequency/week and successful treatment after eight weeks. Success was defined as a defecation frequency > or =3/week and encopresis < or =1 every two weeks. Secondary outcome measures were side effects after eight weeks of treatment.

RESULTS

A total of 91 patients (49 male) completed the study. A significant increase in defecation frequency (PEG 3350: 3 pre v 7 post treatment/week; lactulose: 3 pre v 6 post/week) and a significant decrease in encopresis frequency (PEG 3350: 10 pre v 3 post/week; lactulose: 8 pre v 3 post/week) was found in both groups (NS). However, success was significantly higher in the PEG group (56%) compared with the lactulose group (29%). PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose. However, bad taste was reported significantly more often in the PEG group.

CONCLUSIONS

PEG 3350 (0.26 (0.11) g/kg), compared with lactulose (0.66 (0.32) g/kg), provided a higher success rate with fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation.

Authors+Show Affiliations

Department of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Centre, Amsterdam, the Netherlands. w.p.voskuijl@amc.nl.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

15479678

Citation

Voskuijl, W, et al. "PEG 3350 (Transipeg) Versus Lactulose in the Treatment of Childhood Functional Constipation: a Double Blind, Randomised, Controlled, Multicentre Trial." Gut, vol. 53, no. 11, 2004, pp. 1590-4.
Voskuijl W, de Lorijn F, Verwijs W, et al. PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial. Gut. 2004;53(11):1590-4.
Voskuijl, W., de Lorijn, F., Verwijs, W., Hogeman, P., Heijmans, J., Mäkel, W., Taminiau, J., & Benninga, M. (2004). PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial. Gut, 53(11), 1590-4.
Voskuijl W, et al. PEG 3350 (Transipeg) Versus Lactulose in the Treatment of Childhood Functional Constipation: a Double Blind, Randomised, Controlled, Multicentre Trial. Gut. 2004;53(11):1590-4. PubMed PMID: 15479678.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial. AU - Voskuijl,W, AU - de Lorijn,F, AU - Verwijs,W, AU - Hogeman,P, AU - Heijmans,J, AU - Mäkel,W, AU - Taminiau,J, AU - Benninga,M, PY - 2004/10/14/pubmed PY - 2004/12/16/medline PY - 2004/10/14/entrez SP - 1590 EP - 4 JF - Gut JO - Gut VL - 53 IS - 11 N2 - BACKGROUND: Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative. AIMS: To compare PEG 3350 (Transipeg: polyethylene glycol with electrolytes) with lactulose in paediatric constipation and evaluate clinical efficacy/side effects. PATIENTS: One hundred patients (aged 6 months-15 years) with paediatric constipation were included in an eight week double blinded, randomised, controlled trial. METHODS: After faecal disimpaction, patients <6 years of age received PEG 3350 (2.95 g/sachet) or lactulose (6 g/sachet) while children > or =6 years started with 2 sachets/day. Primary outcome measures were: defecation and encopresis frequency/week and successful treatment after eight weeks. Success was defined as a defecation frequency > or =3/week and encopresis < or =1 every two weeks. Secondary outcome measures were side effects after eight weeks of treatment. RESULTS: A total of 91 patients (49 male) completed the study. A significant increase in defecation frequency (PEG 3350: 3 pre v 7 post treatment/week; lactulose: 3 pre v 6 post/week) and a significant decrease in encopresis frequency (PEG 3350: 10 pre v 3 post/week; lactulose: 8 pre v 3 post/week) was found in both groups (NS). However, success was significantly higher in the PEG group (56%) compared with the lactulose group (29%). PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose. However, bad taste was reported significantly more often in the PEG group. CONCLUSIONS: PEG 3350 (0.26 (0.11) g/kg), compared with lactulose (0.66 (0.32) g/kg), provided a higher success rate with fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/15479678/PEG_3350__Transipeg__versus_lactulose_in_the_treatment_of_childhood_functional_constipation:_a_double_blind_randomised_controlled_multicentre_trial_ L2 - https://gut.bmj.com/lookup/pmidlookup?view=long&amp;pmid=15479678 DB - PRIME DP - Unbound Medicine ER -