Comparing the efficacy of polyethylene glycol (PEG), magnesium hydroxide and lactulose in treatment of functional constipation in children

BACKGROUND: Constipation is one of the common problems in childhood and consists of 3% of referrals to pediatricians and 25% of pediatric gastroenterologists. Aperients are common alternatives for treating chronic constipation. The present study aimed to compare the efficacy of three laxatives [polyethylene glycol (PEG), magnesium hydroxide, and lactulose]. METHODS: In this randomized clinical trial, 1 to 6 year old children with functional chronic constipation (the patients had functional chronic constipation based on ROME III criteria) were studied. 75 patients were divided into three 25 member groups through randomization method. The patients of each group received either of the polyethylene glycol, magnesium hydroxide, or lactulose medications in a standard dosage. After a month, the results were assessed and analyzed through statistical tests. RESULTS: Comparing the frequency of increased defecation in patients of the three groups also found no significant difference among them; however, mean increase of defecation frequency was higher in the magnesium hydroxide group. Compared to patients who had more than three times of defecation per week, PEG group was significantly higher than the other two groups (p < 0.05). Comparing the side effects showed that the prevalence of side effects was lower in the polyethylene glycol group than the other two groups. The patients had a significantly higher satisfaction from the taste of polyethylene glycol and lactulose (p < 0.01). CONCLUSIONS: Although the total mean of increase in defecation frequency after the treatment was higher in the magnesium hydroxide group, the indicator of defecation frequency greater than three times per week was higher in the polyethylene glycol group which indicated the success of treatment in this group. In total, comparing the therapeutic results and satisfaction of the patients, it can be concluded that polyethylene glycol can be used as one of the best alternatives to treat constipation.