Treatment of chronic constipation with lactulose syrup: Results of a double-blind study
Open accessAbstract
Although correction of faulty bowel habits and a change in dietary regimen is helpful in many cases of constipation, there remains a group of patients who cannot easily accept the prescribed regimen, or in whom no desired effect is obtained.It is here that there is a need for effective bowel regulation without the use of drastic laxatives.Because prolonged treatment of what is essentially a harmless disease may be required, a bowel regulator must be carefully chosen.It should have a gentle effect, without any systemic action (presumably therefore not absorbed), no adverse effects such as cramps or salt depletion, and no contraindications, and it must be neither toxic nor habit forming.Since lactulosel, first studied by Mayerhofer and Petuely (1959), largely meets these requirements, we have carried out a double-blind study of the effect of lactulose in patients with severe constipation.Lactulose, ,B-galactosido-fructose, is a synthetic disaccharide which is not digested in the small intestine since the specific disaccharidase is lacking (Dahlqvist and Gryboski, 1965).It passes un- changed into the colon where it serves as an energy source for the carbohydrate-splitting bacteria, predominantly Lactobacillus acidophilus and L.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
There were significant limitations in the 2 RCTs of lactulose: both were conducted over 40 years ago, included relatively small numbers of elderly participants, and did not report diagnostic criteria for constipation.
“There were significant limitations in the 2 RCTs of lactulose; both trials were conducted over 40 years ago, included relatively small numbers of elderly participants, and did not report the diagnostic criteria for constipation. 48,49”
From American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation (2023) · cites this paper as [49]
The paper, published in 1968, describes a randomized, double-blind trial of 103 elderly patients (study description and Experimental Arrangement; page unavailable). But its Discussion explicitly identifies dependence on laxatives for regular bowel activity as the criterion used to identify constipation, so the claim that it reported no criterion is not supported. This paper cannot establish the details of the other cited trial. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Variation of bowel habit in two population samples.
Connell, A. M., Hilton, C., Irvine, G. A., Lennard‐Jones, J. E., & Misiewicz, J. J. (1965) · BMJ · doi:10.1136/bmj.2.5470.1095 · Cited by 378 · see citing works
TREATMENT OF CHRONIC PORTAL-SYSTEMIC ENCEPHALOPATHY WITH LACTULOSE
Müller, J. B., Guggenheim, P., & Haemmerli, U. P. (1966) · The Lancet · doi:10.1016/s0140-6736(66)91573-x · Cited by 164 · see citing works
Inability of the human small-intestinal lactase to hydrolyze lactulose
Dahlqvist, A., & Gryboski, J. D. (1965) · Biochimica et Biophysica Acta (BBA) - Enzymology and Biological Oxidation · doi:10.1016/s0926-6593(65)80082-0 · Cited by 86 · see citing works
Untersuchungen �ber die Wirkungsweise der Lactulose (?-Galactosido-Fructose) im Darm
Hoffmann‐Sommergruber, K., Mossel, D. A. A., Korus, W., et al. (1964) · Journal of Molecular Medicine · doi:10.1007/bf01479054 · Cited by 59 · see citing works
Haenel, H., Feldheim, W., Müller-Beuthow, W., et al. (1958) · PubMed · Cited by 9 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Wiebenga, A. H. Personal communication. on September 23, 2023 by guest. Protected by copyright. http://gut.bmj.com/ Gut: first published as 10.1136/gut.9.1.84 on 1 February 1968. Downloaded from
Cited by
Sorted by citations
Mechanisms, evaluation, and management of chronic constipation
Bharucha, A. E., & Lacy, B. E. (2020) · Gastroenterology · doi:10.1053/j.gastro.2019.12.034 · Cited by 655 · see citing works
Ford, A. C., & Suares, N. C. (2011) · Gut · doi:10.1136/gut.2010.227132 · Cited by 378 · see citing works
Serra, J., Pohl, D., Azpiroz, F., Chiarioni, G., Ducrotté, P., Gourcerol, G., Hungin, A. P. S., Layer, P., Mendive, J., Pfeifer, J., et al. (2020) · Neurogastroenterology & Motility · doi:10.1111/nmo.13762 · Cited by 244 · see citing works
Chang, L., Chey, W. D., Imdad, A., Almario, C. V., Bharucha, A. E., Diem, S., Greer, K. B., Hanson, B., Harris, L. A., Ko, C., et al. (2023) · Gastroenterology · doi:10.1053/j.gastro.2023.03.214 · Cited by 185 · see citing works
Lactulose syrup assessed in a double-blind study of elderly constipated patients
SANDERS, J. F. (1978) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1978.tb01967.x · Cited by 109 · see citing works
Nutritional care of the patient with constipation
Fernández-Bañares, F. (2006) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2005.11.002 · Cited by 65 · see citing works
Pharmacokinetic and pharmacodynamic considerations for the current chronic constipation treatments
Müller-Lissner, S. (2013) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1517/17425255.2013.773972 · Cited by 31 · see citing works
Preventing constipation: a review of the laxative potential of food ingredients
Gélinas, P. (2013) · International Journal of Food Science & Technology · doi:10.1111/j.1365-2621.2012.03207.x · Cited by 26 · see citing works
Yang, L., Zong, Y., Meng, F., Wu, Y., & Zhang, S. (2025) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16844 · Cited by 5 · see citing works
- Authors
- Wesselius-De Casparis, A., Braadbaart, S., Bergh-Bohlken, G. E., & Mimica, M.
- Affiliations
- Philips (Netherlands) (NL)
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1968-02
- Volume
- 9
- Issue
- 1
- Pages
- 84-86
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1552607
- OpenAlex
- W2117853594
- Cited by
- 133
- References
- 5
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 7 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 10 · 2015: 3 · 2014: 2 · 2013: 5 · 2012: 5
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- chronic constipation, lactulose, Lactobacillus acidophilus, colonic fermentation
- MeSH terms
- Aged, Cathartics, Chronic Disease, Clinical Trials as Topic, Constipation, Disaccharides, Female, Glucose, Humans, Male, Placebos
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
