Over-the-Counter Laxative Beats Prescription Drug for Chronic Constipation

A treatment for chronic constipation that is now available over-the-counter was more effective that a drug that needs a doctor’s prescription in a review of ten studies comparing the two.

Both polyethylene glycol, which is marketed as Miralax®, and prescription lactulose, sold under a number of brand names including Cholac Syrup®, Kristalose®, and Enulose®, work by drawing water into the colon and softening stools making them easier to pass.

The two osmotic laxatives can help patients whose intestinal activity is slow because of illness or medicines.  Cancer patients who take opiate pain relievers often have problems with this kind of constipation.

The Cochrane Collaborative reviewed all 10 randomized studies comparing polyethylene glycol to lactulose for chronic constipation.  In all, 322 adults and 546 children were included in their analysis.

They found

Polyethylene glycol (PEG) was better than lactulose in

  • number of stools per week.
  • form of stool.
  • need for additional products to manage constipation.
  • for children, but not adults, amount of abdominal pain.

Authors Conclusion

Polyethylene Glycol should be used in preference to Lactulose in the treatment of Chronic Constipation.

SOURCE: Lee-Robichaud et al.,  Lactulose versus Polyethylene Glycol for Chronic Constipation, Cochrane Database of Systematic Reviews 2010, Issue 7.

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