A recent randomized multicenter study (D Jarzebicka et al. JPGN 2019; 68: 318-24) compared polyethylene glycol 3350 (PEG, aka Miralax) and lactulose for functional constipation in a cohort of 102 patients (12 weeks of treatment and 4 weeks of follow-up).
- PEG 3350 dosing divided into 2 doses:
- <8 kg: 5 g/day
- 8-12 kg: 10 g/day
- 12-20 kg: 15 g/day
- >20 kg: 20 g/day
- Lactulose was given as 1 mL/kg twice a day
A “good clinical outcome” was considered if there were three or more stools per week and an improvement in stool consistency of at least 2 types in the Bristol scale.
- At week 12, a good clinical outcome was noted in 98% of PEG group compared with 90% in the lactulose group
- PEG group had increased defecations relative to lactulose: 7.9 vs. 5.7, less stool retention: 7% vs 10%, and fewer hard stools 7% vs 13%
- Side effects, mainly abdominal pain and bloating, were reported more frequently with lactulose than with PEG: 23 vs 15, P=0.02)
My take: This study showed that PEG 3350 was more effective and had fewer side effects than lactulose for constipation in children between 6 months of age and 6 years.
Related blog posts:
- Expert 2017 Opinion: Miralax is (Still) First Choice Laxative in Children
- PEG 3350 is Not Associated with Elevated Glycol Levels
- Low Adherence Rate with Polyethylene Glycol
- Here we go again…Mirialax Safety
- Miralax -More Scrutiny, Research Study
- Updated Pediatric Expert Constipation Guidelines
- Miralax Safety | gutsandgrowth
- Data Supporting Miralax | gutsandgrowth