期刊论文详细信息
BMC Pediatrics
A randomised, double-blind study of polyethylene glycol 4000 and lactulose in the treatment of constipation in children
Hélène Mathiex-Fortunet2  Philippe Garnier2  Yothi Tongpenyai1  Wandee Varavithya3  Paneeya Pienvichit3  Nipat Simakachorn1  Suporn Treepongkaruna3 
[1] Division of Paediatrics, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand;IPSEN, Boulogne-Billancourt, France;Department of Paediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama 6 Road, Bangkok 10400, Thailand
关键词: Stool frequency;    Children;    Lactulose;    Macrogol;    Constipation;   
Others  :  1138769
DOI  :  10.1186/1471-2431-14-153
 received in 2013-11-21, accepted in 2014-05-30,  发布年份 2014
PDF
【 摘 要 】

Background

Chronic constipation is frequent in children. The objective of this study is to compare the efficacy and safety of PEG 4000 and lactulose for the treatment of chronic constipation in young children.

Methods

This randomised, double-blind study enrolled 88 young children aged 12 to 36 months, who were randomly assigned to receive lactulose (3.3 g per day) or PEG 4000 (8 g per day) for four weeks. The primary efficacy variable was stool frequency during the fourth week of treatment. Secondary outcomes were the number and frequency of subjective symptoms associated with defecation at each visit.

Results

Stool frequency was comparable in the two groups at baseline (lactulose: 0.7 ± 0.5; PEG 4000: 0.5 ± 0.55). Mean stool frequency increased from 0.70 ± 0.50 stools/day at baseline to 0.80 ± 0.41 at Week 4 in the lactulose group and from 0.50 ± 0.55 to 1.10 ± 0.55 stools/day in the PEG 4000 group. A significant difference was observed in the adjusted mean change from baseline, which was 0.15 stools/day in the lactulose group and 0.51 stools/day in the PEG 4000 group, with a least-squares mean difference of 0.36 stools/day [95% CI: 0.16 to 0.56]. With respect to secondary outcome variables, stool consistency and ease of stool passage improved more in the PEG 4000 group (p = 0.001). The incidence of adverse events was similar in both groups, the majority of which were mild.

Conclusions

PEG 4000 has superior efficacy to lactulose for the treatment of chronic constipation in young children and is well tolerated.

Trial registration

US National Institute of Health Clinical Trials database; studyNCT00255372 first registered 17th November 2005.

【 授权许可】

   
2014 Treepongkaruna et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150320092852983.pdf 416KB PDF download
Figure 2. 25KB Image download
Figure 1. 35KB Image download
【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】
  • [1]Loening-Baucke V: Chronic constipation in children. Gastroenterology 1993, 105(5):1557-1564.
  • [2]Taitz LS, Wales JK, Urwin OM, Molnar D: Factors associated with outcome in management of defecation disorders. Arch Dis Child 1986, 61(5):472-477.
  • [3]van den Berg MM, Benninga MA, Di Lorenzo C: Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol 2006, 101(10):2401-2409.
  • [4]Ip KS, Lee WT, Chan JS, Young BW: A community-based study of the prevalence of constipation in young children and the role of dietary fibre. Hong Kong Med J 2005, 11(6):431-436.
  • [5]Zhou H, Yao M, Cheng GY, Chen YP, Li DG: Prevalence and associated factors of functional gastrointestinal disorders and bowel habits in Chinese adolescents: a school-based study. J Pediatr Gastroenterol Nutr 2011, 53(2):168-173.
  • [6]Rowan-Legg A: Managing functional constipation in children. Paediatr Child Health 2011, 16(10):661-670.
  • [7]van Ginkel R, Reitsma JB, Buller HA, van Wijk MP, Taminiau JA, Benninga MA: Childhood constipation: longitudinal follow-up beyond puberty. Gastroenterology 2003, 125(2):357-363.
  • [8]Khan S, Campo J, Bridge JA, Chiappetta LC, Wald A, di Lorenzo C: Long-term outcome of functional childhood constipation. Dig Dis Sci 2007, 52(1):64-69.
  • [9]Schiller LR, Emmett M, Santa Ana CA, Fordtran JS: Osmotic effects of polyethylene glycol. Gastroenterology 1988, 94(4):933-941.
  • [10]Candy D, Belsey J: Macrogol (polyethylene glycol) laxatives in children with functional constipation and faecal impaction: a systematic review. Arch Dis Child 2009, 94(2):156-160.
  • [11]Thomson MA, Jenkins HR, Bisset WM, Heuschkel R, Kalra DS, Green MR, Wilson DC, Geraint M: Polyethylene glycol 3350 plus electrolytes for chronic constipation in children: a double blind, placebo controlled, crossover study. Arch Dis Child 2007, 92(11):996-1000.
  • [12]Nurko S, Youssef NN, Sabri M, Langseder A, McGowan J, Cleveland M, Di Lorenzo C: PEG3350 in the treatment of childhood constipation: a multicenter, double-blinded, placebo-controlled trial. J Pediatr 2008, 153(2):254-261. 261 e251
  • [13]Candy DC, Edwards D, Geraint M: Treatment of faecal impaction with polyethelene glycol plus electrolytes (PGE + E) followed by a double-blind comparison of PEG + E versus lactulose as maintenance therapy. J Pediatr Gastroenterol Nutr 2006, 43(1):65-70.
  • [14]Voskuijl W, de Lorijn F, Verwijs W, Hogeman P, Heijmans J, Makel W, Taminiau J, Benninga M: PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial. Gut 2004, 53(11):1590-1594.
  • [15]Gremse DA, Hixon J, Crutchfield A: Comparison of polyethylene glycol 3350 and lactulose for treatment of chronic constipation in children. Clin Pediatr (Phila) 2002, 41(4):225-229.
  • [16]Dupont C, Leluyer B, Maamri N, Morali A, Joye JP, Fiorini JM, Abdelatif A, Baranes C, Benoit S, Benssoussan A, Boussioux JL, Boyer P, Brunet E, Delorme J, François-Cecchin S, Gottrand F, Grassart M, Hadji S, Kalidjian A, Languepin J, Leissler C, Lejay D, Livon D, Lopez JP, Mougenot JF, Risse JC, Rizk C, Roumaneix D, Schirrer J, Thoron B, et al.: Double-blind randomized evaluation of clinical and biological tolerance of polyethylene glycol 4000 versus lactulose in constipated children. J Pediatr Gastroenterol Nutr 2005, 41(5):625-633.
  • [17]Wang Y, Wang B, Jiang X, Jiang M, Xu C, Shao C, Jia L, Huang Z, Xu X, Liu H, Shang L: Polyethylene glycol 4000 treatment for children with constipation: A randomized comparative multicenter study. Exp Ther Med 2012, 3(5):853-856.
  • [18]Wang BX, Wang MG, Jiang MZ, Xu CD, Shao CH, Jia LY, Huang ZH, Xu XH: Forlax in the treatment of childhood constipation: a randomized, controlled, multicenter clinical study. Zhongguo Dang Dai Er Ke Za Zhi 2007, 9(5):429-432.
  • [19]Loening-Baucke V, Pashankar DS: A randomized, prospective, comparison study of polyethylene glycol 3350 without electrolytes and milk of magnesia for children with constipation and fecal incontinence. Pediatrics 2006, 118(2):528-535.
  • [20]Gomes PB, Duarte MA, Melo Mdo C: Comparison of the effectiveness of polyethylene glycol 4000 without electrolytes and magnesium hydroxide in the treatment of chronic functional constipation in children. J Pediatr (Rio J) 2011, 87(1):24-28.
  • [21]Ratanamongkol F, Lertmaharit S, Jongpiputvanich S: Polyethylene glycol 4000 without electrolytes versus milk of magnesia for the treatment of functional constipation in infants and young children: a randomized controlled trial. Asian Biomed 2009, 3:391-399.
  • [22]Tolia V, Lin CH, Elitsur Y: A prospective randomized study with mineral oil and oral lavage solution for treatment of faecal impaction in children. Aliment Pharmacol Ther 1993, 7(5):523-529.
  • [23]Rafati M, Karami H, Salehifar E, Karimzadeh A: Clinical efficacy and safety of polyethylene glycol 3350 versus liquid paraffin in the treatment of pediatric functional constipation. Daru 2011, 19(2):154-158.
  • [24]Rasquin-Weber A, Hyman PE, Cucchiara S, Fleisher DR, Hyams JS, Milla PJ, Staiano A: Childhood functional gastrointestinal disorders. Gut 1999, 45(Suppl 2):II60-II68.
  • [25]Attar A, Lemann M, Ferguson A, Halphen M, Boutron MC, Flourie B, Alix E, Salmeron M, Guillemot F, Chaussade S, Ménard AM, Moreau J, Naudin G, Barthet M: Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Gut 1999, 44(2):226-230.
  • [26]Gordon M, Naidoo K, Akobeng AK, Thomas AG: Cochrane Review: osmotic and stimulant laxatives for the management of childhood constipation (Review). Evid Based Child Health 2012, 8(1):57-109.
  • [27]North American Society for Pediatric Gastroenterology HaN: Evaluation and treatment of constipation in children: summary of updated recommendations of the north american society for pediatric gastroenterology, hepatology and nutrition. J Pediatr Gastroenterol Nutr 2006, 43(3):405-407.
  • [28]Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS: Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2006, 130(5):1527-1537.
  • [29]Baker SS, Liptak GS, Colletti RB, Croffie JM, Di Lorenzo C, Ector W, Nurko S: Constipation in infants and children: evaluation and treatment. A medical position statement of the north American society for pediatric gastroenterology and nutrition. J Pediatr Gastroenterol Nutr 1999, 29(5):612-626.
  • [30]National Institute for Health and Clinical Excellence: Constipation in children and young people. Diagnosis and management of idiopathic childhood constipation in primary and secondary care. NICE Clinical Guidelines 2010. Available from: http://guidance.nice.org.uk/CG99 webcite
  文献评价指标  
  下载次数:19次 浏览次数:10次