Lancet Child Adolesc Health

PEG edges out other treatments for pediatric constipation: Meta-analysis

October 20, 2025

Study details: This systematic review and meta-analysis evaluated 59 randomized trials involving 7,045 children under 18 with functional constipation. Studies compared pharmacologic therapies—including PEG, lactulose, magnesium compounds, and newer agents—against placebo, no treatment, or other interventions, with a minimum follow-up of two weeks. Outcomes included treatment success, defecation frequency, and adverse event-related withdrawals. Risk of bias was assessed using the Cochrane tool, and evidence certainty was graded using GRADE.

Results: PEG was probably more effective than placebo (RR, 1.74, moderate certainty) and may be more effective than lactulose (RR, 1.35; low certainty). Linaclotide likely increased defecation frequency but showed no clear benefit in treatment success. Prucalopride didn’t demonstrate superiority over placebo. Evidence for other agents was limited or of low certainty.

Clinical Impact: PEG should be considered the standard first-line pharmacologic therapy for pediatric functional constipation. Future trials should use PEG as a comparator and improve methodological transparency to strengthen the evidence base for emerging treatments.

Source:

De Geus, et al. (2025, October 13). Lancet Child Adolesc Health. Efficacy and safety of pharmacological therapies for functional constipation in children: a systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/41101321/