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Lactulose is a non-absorbable sugar used in the treatment of constipation and hepatic encephalopathy. [3] [4] It is administered orally for constipation, and either orally or rectally for hepatic encephalopathy. [3] It generally begins working after 8–12 hours, but may take up to 2 days to improve constipation. [1] [2]
A randomized controlled trial found greater improvement from two sachets (26 g) of PEG versus two sachets (20 g) of lactulose. [22] 17 g per day of PEG has been effective and safe in a randomized, controlled trial for six months. [23] Another randomized, controlled trial found no difference between sorbitol and lactulose. [24]
The main use is for treatment of constipation. In surgery it is used for pre-operative evacuation of the bowel. [3] In diagnostic testing it is used before x-ray examinations or physical examinations of the colon. It is safe for use in children. [4] If used in children under 3 years, it is recommended that the nozzle is only inserted half way. [5]
Docusate is the common chemical and pharmaceutical name of the anion bis(2-ethylhexyl) sulfosuccinate, also commonly called dioctyl sulfosuccinate (DOSS). [2] [3] [4]Salts of this anion, especially docusate sodium, are widely used in medicine as an emollient laxative and as stool softeners, by mouth or rectally. [1]
Pharmacological treatment for children with functional constipation consists of maintenance therapy and faecal disimpaction. High-dose oral polyethylene glycol (PEG) or enemas containing active substances can induce fecal disimpaction, while maintenance therapy is recommended after successful disimpaction to avoid reoccurring stool buildup.
Limited data also support its use for the treatment of fecal impaction. [18] In those with chronic constipation it works better than lactulose. [19] A 2007 comparison showed that people with constipation had a better response to macrogol than to tegaserod. [20] Popular types include: macrogol 3350, [21] macrogol 4000, and macrogol 6000. [22]
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