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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 child who is already toilet trained has at least 1 accident per week involving a bowel movement. Child demonstrates withholding behavior in which he or she actively tries not to pass a bowel movement. Hard stools; Pain with defecation. For children, the degree of constipation may be scored by the Leech or the Barr systems:
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]
The WHO Model List of Essential Medicines for Children (aka Essential Medicines List for Children [1] or EMLc [1]), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe in children up to twelve years of age to meet the most important needs in a health system.
Examples: glycerin suppositories (Hallens), sorbitol, lactulose, and polyethylene glycol (PEG - Colyte, MiraLax) [12] Lactulose works by the osmotic effect, which retains water in the colon; lowering the pH through bacterial fermentation to lactic, formic, and acetic acids; and increasing colonic peristalsis.
This may relieve constipation, one of the causes of encephalopathy, and increase bowel transit. [4] Lactulose and lactitol are beneficial for treating hepatic encephalopathy, and are the recommended first-line treatment. [4] [23] Lactulose does not appear to be more effective than lactitol for treating people with hepatic encephalopathy. [23]
Children with functional constipation can be treated pharmacologically in two stages: maintenance therapy and faecal disimpaction. High-dose oral polyethylene glycol (PEG) or enemas containing active substances such sodium phosphate, sodium lauryl sulfoacetate, or sodium docusate can be used to induce fecal disimpaction. Maintenance therapy is ...
Constipation is the most common chronic gastrointestinal disorder in adults. Depending on the definition employed, it occurs in 2% to 20% of the population. [18] [58] It is more common in women, the elderly and children. [58] Specifically constipation with no known cause affects females more often affected than males. [59]
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