The Effect of Lactulose on the Colon Transit and the Various Symptoms of Constipation in Patients with Functional Constipation

Lee, Joon Seong; Kim, Yong Dae; Im, Hee Hyuk; Cho, Young Man; Jung, In Seop; Koh, Bong Min; Hong, Su Jin; Ryu, Chang Bum; Kim, Jin Oh; Cho, Joo Young; Lee, Moon Sung; Choi, Deuk Lin; Shim, Chan Sup; Kim, Boo Sung

Abstract

BACKGROUND/AIMS: We wanted to evaluate the effect of lactulose on the various symptoms of constipation and colon transit in patients suffering with functional constipation.
METHODS
Colon transit was measured by scintigraphy before and 1 week after lactulose treatment (45-60 ml/day) in 15 female patients with functional constipation. The frequency and severity of constipation symptoms were measured by using an ordinary scale and daily diaries.
RESULTS
There was no significant difference in the geometric centers before and after treatment. Only the t1/2 of the proximal colon tended to be shortened after treatment. In 5 patients with slow transit constipation, lactulose accelerated colonic transit at 48 hours (GC48: 2.6+/-0.6 vs. 3.4+/-1.0, p<0.05) and there was reduction of the t1/2 for proximal colonic emptying (63.5+/-23.2 h vs. 38.9+/-20.1 h, p<0.05). Lactulose increased stool frequency (3.8+/-1.3/wk vs. 6.9+/-3.3/wk, p<0.05), changed the form of the stool (p<0.05), facilitated passage of stool (p<0.01), and improved the frequency and severity of straining, the sensation of anorectal obstruction and the sensation of incomplete evacuation in 15 constipated patients (p<0.05).
CONCLUSIONS
Lactulose improved most of the constipation symptoms in the patients suffering with functional constipation. In the patients with slow transit constipation, these improvements of symptoms may be due to acceleration of the proximal colonic transit via lactulose.