a randomised trial of liquid paraffin versus lactulose in the treatment of chronic functional constipation in children

liquid paraffin has been suggested as a good laxative comparing to lactulose as a treatment option in pediatric constipation. this study was performed to compare liquid paraffin with lactulose in pediatric constipation. a total of 247 patients (127 males and 120 females) aged 2-12 years (mean 4.1 ± 2.7 years) with chronic functional constipation were included in an 8 week, randomized, controlled trial. after faecal disimpaction, patients received oral liquid paraffin (1-2 cc/kg/day) or lactulose (1-2 cc/kg/day). primary outcome measures were: defecation and encopresis frequency per week and successful treatment after 8 weeks. success was defined as a defecation frequency ≥ 3 per week and encopresis ≤ 1 every two weeks. secondary outcome measures were side effects during 8 weeks of treatment. a significant increase in defecation frequency, liquid paraffin group, 3 pre, versus, 12 post treatment per week and lactulose group: 3 pre, versus 8 post, per week was found. a significant decrease in encopresis frequency, liquid paraffin: 10 pre, versus 1 post per week; lactulose: 9 pre, versus 3 post per week, was found in both groups. however success was significantly higher in the liquid paraffin group (85%) compared with the lactulose group (29%). liquid paraffin patients reported less abdominal pain, straining and pain at defecation than children using lactulose. liquid paraffin is more effective than lactulose in the treatment of chronic functional constipation of childhood. it provided a higher success rate with fewer side effects. liquid paraffin should be the laxative of first choice in childhood functional constipation.