We searched MEDLINE(®) and Embase, with no date or language restrictions, for studies of
lactitol supplementation on adult
constipation. A random-effects meta-analysis was performed on pre- to posttreatment changes in stool frequency and consistency with
lactitol among all studies, as well as a comparison of efficacy and tolerance outcomes in randomized controlled trials (RCTs) of
lactitol versus
lactulose.
RESULTS: A total of eleven studies representing 663 distinct patients were included in the final analysis, including five single-arm studies, four RCTs comparing
lactitol with
lactulose, one RCT comparing
lactitol with placebo, and one nonrandomized controlled trial comparing
lactitol with stimulant laxatives. Weekly stool frequency was significantly increased with
lactitol compared with baseline (standardized mean difference [SMD]: 1.56, P<0.001). Stool consistency also improved over the supplementation period with
lactitol (SMD: 1.04, P<0.001). Approximately one-third of patients experienced an adverse event; however, symptoms were generally mild and rarely (5%) resulted in study withdrawal. In RCTs of
lactitol versus
lactulose,
lactitol was slightly more effective than
lactulose in increasing weekly stool frequency (SMD: 0.19, P=0.06). No statistically significant differences between
lactitol and
lactulose were identified in any other efficacy or tolerance outcome.
Lactitol demonstrated favorable efficacy and tolerance in individual studies when compared to stimulant laxatives and placebo.
CONCLUSION:
Lactitol supplementation is well tolerated and improves symptoms of adult
constipation. The efficacy and tolerance of
lactitol and
lactulose are similar, with a trend for more frequent stools with
lactitol. Limited evidence suggests
lactitol is superior to stimulant laxatives and placebo for relieving
constipation symptoms.