title: Can partially hydrolyzed guar gum be an alternative to lactulose in treatment of childhood constipation?
abstract: OBJECTIVE
  In the present study, we aimed to investigate if partially hydrolyzed guar gum (PHGG) can be used safely as a fiber source for treatment of constipation in children and to compare its success with the most commonly used osmotic laxative, lactulose.
  
  
  METHODS
  A randomized prospective controlled study on 61 patients (partially hydrolyzed guar gum group, n: 31; lactulose group, n: 30) was performed. Patients were given lactulose or partially hydrolyzed guar gum for four weeks. Using a standardized bowel diary, defecation frequency, stool consistency, and presence of flatulence and abdominal pain were recorded. Family questionnaires about the success, safety and side effect profile of both treatment arms were also obtained.
  
  
  RESULTS
  No significant differences were found in the baseline daily fiber (fruits and vegetables) intake between the two groups. Bowel movement frequency per week and stool consistency improved significantly in both treatment groups (p<0.05). The percent of children with abdominal pain and stool withholding also decreased eminently in both groups (p<0.05). Weekly defecation frequency increased from 4±0.7 to 6±1.06 and from 4±0.7 to 5±1.7 in the lactulose and partially hydrolyzed guar gum treated groups, respectively (p<0.05). According to the family questionnaire, the parents complained of bad taste, flatulence and necessity to ingest a high amount of drug in the lactulose treatment group. In the partially hydrolyzed guar gum treatment group, parents were satisfied with the defecation frequency of their children.
  
  
  CONCLUSIONS
  Treatment with partially hydrolyzed guar gum is as effective as lactulose treatment in relieving stool withholding and constipation-associated abdominal pain, and its use improves stool consistency. Lactulose seemed to have more side effects, including flatulence and sensation of bad taste.
authors.affiliation: Department of Pediatric Gastroenterology, Zonguldak Karaelmas University, School of Medicine, Zonguldak. gonnazyuc@yahoo.com
authors.forename: Gonca
authors.initials: G
authors.lastname: Üstündağ
authors.forename: Zarife
authors.initials: Z
authors.lastname: Kuloğlu
authors.forename: Nihan
authors.initials: N
authors.lastname: Kirbaş
authors.forename: Aydan
authors.initials: A
authors.lastname: Kansu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000188:drug therapy*; D004043:Dietary Fiber / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005414:Flatulence / Q000139:chemically induced; D005685:Galactans / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry; D006801:Humans; D006868:Hydrolysis; D007792:Lactulose / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008351:Mannans / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry; D017060:Patient Satisfaction; D053149:Plant Gums / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry; D011446:Prospective Studies; D013651:Taste Disorders / Q000139:chemically induced
chemical_list: D004043:Dietary Fiber; D005685:Galactans; D008351:Mannans; D053149:Plant Gums; D007792:Lactulose; C007894:guar gum