TOPLINE:

Polyethylene glycol was more effective than placebo in treating functional constipation in children and might be more effective than lactulose.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis of 59 randomized controlled trials to evaluate the efficacy and safety of pharmacologic therapies for functional constipation in children.
• This study involved 7045 children aged 18 years or younger (48% girls) across the world.
• Pharmacologic interventions, such as polyethylene glycol, lactulose, magnesium hydroxide, and linaclotide, were included and compared against placebo or other treatments, with a minimum follow-up duration of 2 weeks.
• Main outcomes were the success of the treatment, frequency of defecation, and withdrawals due to adverse events. Secondary outcomes included painful defecation, stool consistency, and quality of life.

TAKEAWAY:

• Polyethylene glycol showed higher treatment success than placebo (risk ratio [RR], 1.74; 95% CI, 1.25-2.41; two studies; moderate certainty).
• Polyethylene glycol may be more effective than lactulose (RR, 1.35; 95% CI, 1.11-1.64; five studies; low certainty).
• Polyethylene glycol vs magnesium hydroxide led to fewer withdrawals due to adverse events, with withdrawal rates of 6% vs 17% (RR, 0.38; 95% CI, 0.16-0.92; three studies; moderate certainty).

IN PRACTICE:

“Polyethylene glycol should be considered the first-line treatment for standard care,” the authors of the study wrote.

SOURCE:

The study was led by Anna de Geus, Emma Children’s Hospital in the Amsterdam UMC at the University of Amsterdam, Netherlands, and Morris Gordon, PhD, School of Medicine at the University of Central Lancashire in Preston, England. It was published online on October 13, 2025, in The Lancet Child & Adolescent Health.

LIMITATIONS:

The reliance on authors’ definitions of functional constipation may have affected which therapies were included. The broad scope of the review excluded nonpharmacologic treatments that could be important for complete care.

DISCLOSURES:

This study did not receive any specific funding. One author disclosed receiving consulting fees from several companies, including Coloplast and Danone.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.