[Crystalline lactulose and oral preparations of micro-organisms for the treatment of chronic aspecific diarrhea in children. A controlled clinical study]

Abstract

Aspecific chronic diarrhea is one of the most common causes of protracted diarrhea in infancy. The pathology is characterised by an increased frequency of daily bowel movement with half-formed feces; it is not associated to malabsorption syndrome or enteric infections and appears to be correlated to an unbalanced diet and changes in microflora involved in the fermentation processes. A controlled randomised single-blind clinical trial was performed, using commercially available crystalline lactulose and lactic enzymes, in order to normalise the modified intestinal ecosystem. Twenty-four children (mean age 21.76 months) affected by aspecific chronic diarrhea were studied; weight and height parameters were not influenced. Patients were first divided by age and then randomly divided into two groups of 12. Group 1 received treatment with crystalline lactulose (Laevolac crystals, BBR) and Group 2 received lyophilised Lactipan. In both cases treatment continued for 15 days. At the end of the trial all subjects showed a complete remission of intestinal disorders. Children in Group 1 showed more fully formed feces following treatment. Fecal pH values were considerably reduced only in those subjects treated with crystalline lactulose. In the latter subjects H2 excretion diminished during the trial, a fact which may probably be attributed to reduced colic pH values. On the basis of these results, it is possible to conclude that both treatments proved efficacious. The re-establishment of a balanced intestinal ecosystem remains the choice treatment for subjects affected by aspecific chronic diarrhea.