Subtype Classification of Functional Constipation in Child: PEG versus Lactulose.

BACKGROUND: This study aimed to evaluate the usefulness of subtype classification of functional childhood constipation with colon transit time (CTT) test from a therapeutic perspective: polyethylene glycol (PEG) 4000 versus lactulose. METHODS: A total of 190 children were enrolled in this study, which was based on highly refined data collected from a defecation diary, CTT test, and medical records. RESULTS: Generally, PEG 4000 was prescribed in 51.1% (N=47/92) of normal transit type (NT) and 91.8% (N=90/98) of abnormal transit type (P<0.001). In terms of subtype of CTT test, PEG 4000 was prescribed in 51.1% (N=47/92) of NT, 96.2% (N=25/26) of outlet obstruction type (OT), and 90.3% (N=65/72) of slow transit type (ST) (P < 0.001). PEG 4000 was administered in 97.2% (N=35/36) of the fecal incontinence group and 66.2% (N=102/154) of the non-fecal incontinence group (P<0.001). In the non-fecal incontinence group, PEG 4000 was prescribed in 47.3% (N=40/84) of NT, 94.4% (N=17/18) of OT, and 86.5% (N=45/52) of ST (P<0.001). In the fecal incontinence group, PEG 4000 was prescribed in 87.5% (N=7/8) of NT, 100% (N=8/8) of OT, and 100% (N=20/20) of ST (P = 0.165). CONCLUSIONS: Subtype classification of functional constipation based on CTT test provides important implications for initial choice of drugs in children.