Lactulose Syrup Assessed in a Double‐Blind Study of Elderly Constipated Patients

Abstract

The laxative effects of 50% lactulose syrup and 50% glucose syrup were compared in a 12-week, double-blind study of 47 elderly constipated patients living in a nursing home. The dosage was 30 ml daily taken at bedtime; it was reduced to 15 ml if the initial dosage produced two or more bowel movements daily. The number of bowel movements during treatment in comparison to pretreatment was significantly increased in the 42 patients (19 lactulose, 23 glucose) who completed at least 8 weeks of the study. Laculose was superior to glucose in the mean number of bowel movements per day (p less than 0.02) and in the percentage of days in which at least one bowel movement occurred (p less than 0.05). Reduction in the severity of each 5 symptoms (cramping, griping, flatulence, tenesmus, bloating) was greater with lactulose. For relief of all 5 symptoms, lactulose was significantly more effective than glucose (p less than 0.04). The striking reduction in the number of fecal impactions (only 6 in the lactulose patients vs 66 in the controls) was highly significant (p less than 0.015). The lactulose patients needed fewer enemas than did the controls. No abnormal values were observed in laboratory tests.

The Treatment of Chronic Constipation in Adults A Systematic Review

“…50 Seven trials evaluated bowel frequency for 1 to 4 weeks after discontinuation of interventions. 26,29,34,35,40,41,43 All showed decreased frequency with discontinuation of therapy.…”

“…52 Another trial showed dorbanex (surfactant plus irritant) resulted in improved consistency compared with laxoberal (irritant). 57 Only one trial showed a significant decrease in the number of fecal impactions among nursing home residents with lactulose compared with placebo, 35 but most trials (n ϭ 34) did not evaluate this outcome.…”

“…28,31,33,38,40,53,58,59 Thirtyseven percent of the participants were described as having fewer than three bowel movements per week, which was a stated entry criterion in 15 trials. 24,32,[35][36][37]40,43,45,48,51,[53][54][55][56]59 Specific symptoms of constipation such as straining, passing hard stools, abdominal pain, and inability to defecate when desired were used as part of the entry criteria in nine trials involving 277 persons. 24,32,33,35,38,41,42,53,59 Whether the constipation was secondary to motility dysfunction or pelvic floor dysfunction was only stated in three trials.…”

“…24,32,[35][36][37]40,43,45,48,51,[53][54][55][56]59 Specific symptoms of constipation such as straining, passing hard stools, abdominal pain, and inability to defecate when desired were used as part of the entry criteria in nine trials involving 277 persons. 24,32,33,35,38,41,42,53,59 Whether the constipation was secondary to motility dysfunction or pelvic floor dysfunction was only stated in three trials. 31,32,38 One small trial involved 10 persons with pelvic floor dysfunction, 32 and two others involved 37 persons with motility dysfunction.…”

Polyethylene glycol 3350 in occasional constipation: A one-week, randomized, placebo-controlled, double-blind trial

“…Preference questionnaires were presented as binary outcomes and analyzed using CMH and ANOVA. [27,28] , tegaserod [29] , prucalopride, lubiprostone, and linaclotide [30] , as well as PEG [19,[22][23][24][25] for the treatment of chronic constipation. However, there are no reports on the effectiveness of PEG 3350 for the treatment of occasional constipation.…”