Shatnawi Mohammad Salem, Alrwalah Mohammad Mu'azi, Ghanma Abdulla Majed, Alqura'an Mohammad Lutfi, Zreiqat Ehab Nequla, Alzu'bi Manar Mohammad
Lieutenant Colonel, Senior Pediatric Gastroenterologist, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Royal Medical Services, Amman, Jordan.
Brigadier, Head of Pediatric Gastroenterology Department, Consultant Pediatric Gastroenterologist, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Royal Medical Services, Amman, Jordan.
Sudan J Paediatr. 2019;19(1):31-36. doi: 10.24911/SJP.106-1546805996.
Faecal disimpaction is very important for successful management of the constipation in children. Lactulose is cheap and widely available medicine compared to other polyethylene glycol (PEG) preparations. From our experience, lactulose is effective and safe medicine for both disimpaction and maintenance therapy in constipated children. The purpose of the present study was to evaluate the safety and efficacy of lactulose in faecal impaction management in children with constipation. We conducted a prospective controlled trial in children with functional constipation, who presented with faecal impaction to Queen Rania Hospital for Children from April 15, 2018 until October 15, 2018. Two randomised matched groups; group A included 33 constipated children treated for disimpaction with higher dose lactulose (10 g/15 ml) 4-6 ml/kg/day (max. 120 ml/day) and group B included 32 children treated for disimpaction with macrogol (PEG 4000) 1-1.5 g/kg (max. 30 g/day). Both groups received treatment until resolution or up to 6 days. Patients were followed over 1 week and success of disimpaction was observed. Moreover, any adverse events were recorded. All the patients in both groups achieved successful disimpaction by seventh day of the therapy, group B showed significant faster response. Both therapies were tolerated and no significant adverse events were reported. Both agents were safe, effective and well tolerated. Lactulose may be a good alternative to PEG in the treatment of faecal impaction in constipated children.
粪便清除对于成功治疗儿童便秘非常重要。与其他聚乙二醇（PEG）制剂相比，乳果糖是一种价格低廉且广泛可得的药物。根据我们的经验，乳果糖对于便秘儿童的粪便清除和维持治疗都是一种有效且安全的药物。本研究的目的是评估乳果糖在便秘儿童粪便嵌塞治疗中的安全性和有效性。我们对2018年4月15日至2018年10月15日期间因粪便嵌塞到拉尼亚王后儿童医院就诊的功能性便秘儿童进行了一项前瞻性对照试验。将患儿随机分为两个匹配组；A组包括33名便秘儿童，用高剂量乳果糖（10 g/15 ml）4 - 6 ml/kg/天（最大120 ml/天）进行粪便清除治疗，B组包括32名儿童，用聚乙二醇（PEG 4000）1 - 1.5 g/kg（最大30 g/天）进行粪便清除治疗。两组均接受治疗直至症状缓解或最长6天。对患者进行1周的随访，观察粪便清除的成功情况。此外，记录任何不良事件。两组所有患者在治疗第7天均实现了成功的粪便清除，B组的反应明显更快。两种治疗方法耐受性良好，未报告明显不良事件。两种药物均安全、有效且耐受性良好。在治疗便秘儿童的粪便嵌塞方面，乳果糖可能是PEG的一个良好替代药物。
