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| |  DG DISPATCH - WCPGHN: Lactitole Effective And Highly Tolerable For Chronically Constipated Children By Maria Bishop Special to DG News
BOSTON, MA -- August 9, 2000 -- Randomized clinical trials of alternative therapies for children with chronic functional constipation (CFC) are conspicuously unavailable. To demonstrate the efficacy and tolerability of lactitole in treating children with CFC, Italian researchers compared polyethylene glycol and lactitole in children with this condition. Results of the randomized, open-label, prospective study, led by A. Tozzi, MD, active member of the pediatrics staff at Universita di Napoli Frederico II, Naples, Italy, were presented during a poster session at the first World Congress of Pediatric Gastroenterology, Hepatology and Nutrition in Boston, MA. While polyethylene glycol (PEG) solution is a traditional treatment for constipation, children don't tolerate this therapy very well, according to the researchers. Patients in this study were randomised to receive either lactitole (1 to 2 g/kg/day) or PEG solution (7-10 ml/kg twice daily) for eight weeks. Stool habits and segmental transit time (SGTT) were assessed using radio-opaque markers before and after treatment. Of the 34 children, only 21 completed the study; seven patients on PEG were withdrawn for lack of compliance. Results showed that nine patients completed the treatment with lactitole, and 12 patients completed the treatment with PEG. Both lactitole and PEG significantly increased stool frequency (1.57 +/- 2.5 stools per week to 7.0 +/- 3.74 stools per week for lactitole and 1.6 +/- 2.6 stools per week to 5.7 +/- 1.35 stools per week for PEG). Both treatments also significantly decreased encopresis and suppository use. Before treatment, the SGTT of patients in the lactitole group showed five patients with rectal delay and four patients with rectocolonic delay. After treatment, there was rectal delay in five patients, but four patients showed a normal transit time. In the PEG group, before treatment, SGTT showed a rectal delay in seven patients and rectocolonic delay in five patients. After treatment, there was rectal delay in three patients, rectocolonic delay in three patients and normal transit time in six patients. Dr. Tozzi concluded that "either treatment is effective in improving bowel frequency, encopresis and SGTT in children with functional constipation. The use of PEG, however, is limited because of low compliance with the drug." Chronic constipation in children can be the first sign of a more serious bowel problem, and requires serious consideration by primary-care physicians.
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