title: Polyethylene glycol 4000 vs. lactulose for the treatment of neurogenic constipation in myelomeningocele children: a randomized-controlled clinical trial.
abstract: OBJECTIVE
  To compare the therapeutic effectiveness and tolerability of low daily doses of polyethylene glycol 4000 vs. lactulose in the treatment of neurogenic constipation in children with myelomeningocele.
  
  
  METHODS
  Sixty-seven children with chronic neurogenic constipation were randomized allocated to receive either polyethylene glycol 4000 (0.50 g/kg) or lactulose (1.5 g/kg) for 6 months. Patients or their parents reported frequency and modality of evacuation and side effects on a diary card. Primary outcome was bowel frequency > or =3/week, and the second one was side effects at the end of treatment.
  
  
  RESULTS
  Complete remission of constipation was reported by a significantly (P < 0.01) higher number of patients treated with polyethylene glycol compared with lactulose. At the end of the study, 46% patients of polyethylene glycol group and 22% of the lactulose group were asymptomatic. Compared with lactulose, patients treated with polyethylene glycol reported higher bowel frequency (5.1 vs. 2.9 bowel movements/week, P < 0.01) and reduction of encopresis. Neither lactulose nor polyethylene glycol caused clinically-significant serious side effects and palatability was similar.
  
  
  CONCLUSIONS
  Polyethylene glycol 4000 compared with lactulose provided a higher success rate, without significant side effects, for the treatment of constipation in myelomeningocele children.
authors.affiliation: Department of Paediatric Science, Catholic University Medical School, Rome, Italy. c.rendeli@libero.it
authors.forename: C
authors.initials: C
authors.lastname: Rendeli
authors.forename: E
authors.initials: E
authors.lastname: Ausili
authors.forename: F
authors.initials: F
authors.lastname: Tabacco
authors.forename: B
authors.initials: B
authors.lastname: Focarelli
authors.forename: A
authors.initials: A
authors.lastname: Pantanella
authors.forename: C
authors.initials: C
authors.lastname: Di Rocco
authors.forename: O
authors.initials: O
authors.lastname: Genovese
authors.forename: C
authors.initials: C
authors.lastname: Fundarò
mesh_terms: D000704:Analysis of Variance; D002400:Cathartics / Q000627:therapeutic use*; D002648:Child; D003248:Constipation / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007792:Lactulose / Q000627:therapeutic use*; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000188:drug therapy; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012997:Solvents / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D002400:Cathartics; D012997:Solvents; D011092:Polyethylene Glycols; D007792:Lactulose