Kobieta podaje dziecku lekarstwo Laktuloza – czy jest skuteczna w walce z zaparciami? /fot. Adobe Stock

Laktuloza – czy jest skuteczna w walce z zaparciami?

Laktuloza to syntetyczny dwucukier, który w niewielkim stopniu wchłania się z przewodu pokarmowego. Często stosowana jest w przypadku przewlekłych zaparć. Czy przyjmowanie laktulozy jest skutecznym sposobem w walce z problemami z wypróżnieniem? Badania wskazują, że lepszym preparatem na zaparcia u dzieci są makrogole.

Spis treści:

Co to jest laktuloza i jak działa na układ trawienny?

Laktuloza jest syntetycznym dwucukrem składającym się z galaktozy połączonej z fruktozą. Wykazuje działanie przeczyszczające, dlatego bywa stosowana w leczeniu zaparć. Laktuloza pod wpływem flory bakteryjnej rozkładana jest w okrężnicy do kwasów organicznych (kwasu mlekowego, mrówkowego i octowego) oraz dwutlenku węgla. Związki, które powstają z rozpadu laktulozy, powodują zwiększenie ilości wody w jelicie grubym, a także pobudzenie perystaltyki jelit. Laktuloza zakwasza treści jelita grubego, a tym samym przyspiesza reakcję przekształcania jonów amonowych do amoniaku i zmniejsza wchłanianie amoniaku do krwi. Zwiększona zawartość wody powoduje zwiększenie treści mas kałowych i rozluźnienie stolca. Przyspieszenie perystaltyki jelit sprawia, że wypróżnienie staje się łatwiejsze. U części pacjentów laktuloza powoduje jednak wystąpienie działań niepożądanych, takich jak wzdęcia, ból brzucha i bulgotanie treści jelitowej1.

Wątpliwości dotyczące bezpieczeństwa i skuteczności laktulozy w leczeniu zaparć u dzieci

Laktuloza dla dzieci – czy warto?

Laktuloza jest popularnym środkiem stosowanym w wielu krajach w walce z zaparciami u dzieci. Preparat ten zazwyczaj podawany jest w postaci syropu, który można wymieszać z wodą. Jak jednak wynika z badań przeprowadzonych w 2004 roku przez naukowców z trzech holenderskich szpitali, którzy porównywali skuteczność makrogoli 3350 i laktulozy w leczeniu zaparcia czynnościowego u dzieci, podczas stosowania laktulozy dochodzi do fermentacji, która może doprowadzić do wzdęć i bólu brzucha, a skuteczność leczenia małych pacjentów laktulozą w stosunku do tych leczonych makrogolem jest mniejsza1.

Dodatkowo przeciwwskazaniem do przyjmowania laktulozy jest uczulenie na substancję czynną, dziedziczna nietolerancja galaktozy lub fruktozy, a także zespół złego wchłaniania glukozy-galaktozy. Nie powinno się jej stosować u dzieci z pierwotnym niedoborem laktazy.

Dlatego, choć laktuloza należy do popularnych preparatów, wielu pediatrów odradza jej stosowanie i proponuje, by zastąpić ją innymi lekami. Od kilkunastu lat alternatywnymi lekami pierwszego wyboru w leczeniu zaparcia czynnościowego są polietylenowe glikole (makrogole, PEG) o masie < 4000. „Analizując bezpieczeństwo PEG 3350 w trakcie badania oraz podczas 24-tygodniowego okresu obserwacji stwierdzono znamiennie rzadsze występowanie objawów niepożądanych, takich jak: ból brzucha oraz bolesne defekacje w grupie otrzymującej PEG 3350” – czytamy we wnioskach omawianego powyżej badania. Jak zauważono, dzieci chętniej przyjmowały makrogole, skarżąc się na smak laktulozy1.

 

Spróbuj naszego ebooka z przepisami wegetariańskimi dla maluchów zmagających się z czynnościowymi zaparciami! Opracowany przez specjalistę w dziedzinie dietetyki klinicznej i dziecięcej, pomoże Ci zapewnić właściwą ilość błonnika i płynów, dostosowaną do wieku Twojego dziecka. Znajdziesz w nim informacje na temat różnych diet wegetariańskich oraz przepisy zgodne z zasadami diety laktoowowegetariańskiej. Sprawdź!

POBIERZ EBOOK

Bezpieczne alternatywy dla laktulozy w leczeniu zaparć u dzieci

Leczenie zaparć u dzieci jest procesem długotrwałym, warto podejść do niego wieloczynnikowo. Istotną rolę odgrywa zadbanie o prawidłowe nawyki.

  • zbilansowana dieta – niekiedy to złe nawyki żywieniowe są główną przyczyną zaparć u dziecka. Do codziennego menu warto włączyć produkty zawierające dużą ilość błonnika, którego źródłem są np. produkty pełnoziarniste, kasze, surowe warzywa i owoce. Błonnik drażni ścianki jelit, co poprawia ich ukrwienie. Pobudza perystaltykę jelit, co prowadzi do regularnych wypróżnień i zapobiega zaparciom. Polecane są również ziołowe napary: rumianek, melisa, mięta, owoce dzikiej róży.
  • prawidłowe nawodnienie organizmu – odpowiednie nawodnienie organizmu jest szczególnie istotne podczas leczenia zaparć. Kiedy dziecko pije zbyt małą ilość wody, organizm próbuje ją zaoszczędzić i odciąga z jelit, co powoduje zagęszczenie stolca.
  • regularna aktywność fizyczna – aktywność fizyczna wzmaga ruchy perystaltyczne jelit, dlatego w szczególności zalecana jest dzieciom, u których pojawia się problem zaparć.

Zaparcia u dzieci można leczyć produktami farmakologicznymi, równocześnie stosując metody niefarmakologiczne. Makrogole (polietylenoglikole – PEG) to leki będące skondensowanymi polimerami eteru etylowego i wody. Są lekiem pierwszego rzutu w leczeniu zaparć, a rekomendowany czas leczenia w fazie odblokowania jelita wynosi od 3 do 6 dni2. Z z rekomendacjami Polskiego Towarzystwa Gastroenterologii, Hepatologii i Żywienia Dzieci celem drugiego etapu leczenia jest doprowadzenie do prawidłowego rytmu wypróżnień i konsystencji stolca. Leczenie polega na podawaniu makrogoli przez dłuższy czas w dawce 0,4-0,8 g/kg m.c./24 h. Dawka ta następnie może być modyfikowana w zależności od uzyskanych efektów.

Źródła:

1 W. Voskuijl, F. de Lorijn, W. Verwijs, P. Hogeman, J. Heijmans, W. Mäkel, J. Taminiau, M. Benninga, PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial, Gut, 2004; 53: 1590-1594, https://pubmed.ncbi.nlm.nih.gov/15479678/ [dostęp: 15.05.2023 r.]

2 Rozpoznawanie i leczenie zaparcia czynnościowego u niemowląt, dzieci i młodzieży. Stanowisko i zalecenia Polskiego Towarzystwa Gastroenterologii, Hepatologii i Żywienia Dzieci, podyplomie.pl, czerwiec 2022

Sprawdź powiązane tematy

Posłuchaj podcastów stworzonych przez mamy dla mam!

Sprawdź
Dear User!

Before you click "Go to the Website" or close the window by clicking ×, please read the following information, as it concerns your personal data.

By clicking "Go to the website" or by closing this window, you consent to the processing of your personal data on the terms described below.

The administrator of personal data of people visiting our websites is USP Zdrowie sp. z o.o. with headquarters in Poleczki 35 street, Warsaw 02-822, Poland.

As part of USP Zdrowie services, we will collect information about the use of our websites. The scope of data collected by us includes, among others information stored in cookies, user's IP, as well as information about your device and browser.

Your data will be used by us for the following purposes: (i) providing you with access to a safe and functional website; (ii) conducting analyzes that allow to study the ways of using our websites and use their functionalities and content, as well as to improve and streamline them; (iii) marketing, including presenting you with advertisements and messages tailored to your interests and preferences (profiling).

The use of our websites will involve the use of technologies provided by third parties (e.g. Google, Facebook). As USP Zdrowie, we provide you with the opportunity to consent to the transfer of your data to the groups of recipients indicated by us by accepting all or some of the purposes of processing.

USP Zdrowie provides each user of our websites with the opportunity to exercise the right to request access to his personal data, rectify it, delete or limit processing, exercise the right to object to processing, as well as the right to transfer data. in the event that the legal basis for the processing of your personal data is your consent - we provide you with the possibility of withdrawing it at any time through dedicated mechanisms for managing privacy settings.

You can contact USP Zdrowie by: (i) sending an e-mail to the following address: daneosoboweusp@usp.pl; (ii) sending a letter to the following address: USP Zdrowie sp. z o.o., Poleczki 35 street, Warsaw 02-822, Poland.

Detailed information related to the rules for the processing of your personal data on individual USP Zdrowie websites can be found in our Privacy Policy (PL).

Below you can choose to accept all or some of the processing purposes. We will be happy if you decide to help us improve our services and websites!

Choose services
Service Description State
Solutions necessary to provide the service by electronic means
as part of our Websites, we use the localStorage solution. localStorage is a file created by the user's browser installed on his device. Thanks to the localStorage mechanism, we are able to provide our users with access to efficient and safe websites and the ability to use their functionalities (e.g. remembering your privacy settings and the possibility of changing them, remembering preferences related to the selected language of displaying the website, the ability to add products to the basket). Information saved and used as part of the localStorage mechanism will not be used to conduct marketing activities. The localStorage mechanism is necessary to provide our services in the form of Websites (Article 6 (1) (b) of the GDPR).
Analytical cookies:
cookies that are used for advanced analysis of user behavior on our websites. Analytical cookies are used, among others to analyze user behavior on Websites in order to optimize the appearance, content and functionality of websites. The legal basis for the processing of these types of cookies is your voluntary consent (Article 6 (1) (a) of the GDPR), which you can express and withdraw at any time using the functionality of our websites. Currently, USP Zdrowie uses the following analytical cookies:
Google Analytics an online tool for analyzing website statistics. The tool allows us to track traffic on our websites, including the ability to analyze user behavior on websites. Based on the data collected using Google Analytics, we are able to develop our websites and provide a friendly appearance of the website and add new, useful functionalities. Google Analytics is provided and operated by Google Ireland Limited. More information on the rules governing the processing of personal data by Google can be found here: https://policies.google.com/privacy?hl=en
Google Tag Manager tag management system developed by Google to manage JavaScript and HTML tags used for tracking and analysis on websites. Google Tag Manager is provided and operated by Google Ireland Limited. More information on the principles of personal data processing by Google can be found here: https://policies.google.com/privacy?hl=en
HotJar tool for analyzing user behavior on the website using, among others heat maps (analysis of the user's cursor behavior on the website). With this tool, we can design our websites more effectively and improve their readability and functionality. HotJar is provided and operated by Hotjar Limited. More information on the principles of personal data processing by HotJar can be found here: https://help.hotjar.com/hc/en-us/categories/115001323967-About-Hotjar
Marketing cookies:
cookies that allow us to conduct activities related to the promotion of our services, products and websites. This category of cookies will be used, inter alia, in order to show you advertisements tailored to your preferences or provide other marketing content. The legal basis for the processing of these types of cookies is your voluntary consent (Article 6 (1) (a) of the GDPR), which you can express and withdraw at any time using the functionality of our websites. Currently, USP Zdrowie uses the following marketing cookies:
Facebook Pixel the Facebook Pixel tool is a piece of code on the website that allows you to measure, optimize and create groups of recipients of advertising campaigns on Facebook. The operation of this tool enables us to run more effective advertising campaigns and provide you with content that may be of real interest to you. Facebook Pixel is provided and operated by Facebook Ireland Limited. Facebook Pixel collects basic information stored in the cookie and information about the website and your activity. Facebook Ireland Limited may transfer personal data of its users to the United States of America, based on the legal mechanisms provided for in applicable law. The basis for the transfer of your data in some cases may also be your consent, which we collect as part of our websites. therefore, we would like to draw your attention to the fact that the law on the protection of personal data in the United States of America differs from European legislation and may not provide you with the same rights as those provided for by the provisions in force in Poland, and in some cases it may also combine with the possibility of access to your data by the authorities and services of a third country. in order to ensure the fullest protection of your rights and freedoms, the mechanisms used as part of the Facebook Pixel tool prevent your identification data from being identified and are subject to automatic processes of their removal in short periods.

We would also like to inform you that when using the Facebook Pixel USP Zdrowie tool, it complies with the current Regulations of Facebook Business Tools, including the agreements on the principles of co-administration of personal data. in order to fulfill the obligation resulting from the provisions of data protection law, we would like to inform you that in the scope of processing information collected using the Facebook Pixel tool:
  1. USP Zdrowie and Facebook Ireland Limited, with its registered office at 4 Grand Canal Square, Grand Canal Harbor, Dublin 2, Ireland, act as joint controllers (entities jointly deciding on the purposes and methods of personal data processing).
  2. USP Zdrowie and Facebook Ireland Limited have made joint arrangements regarding the performance of their obligations under the provisions of the GDPR.
  3. USP Zdrowie and Facebook Ireland Limited are responsible for providing appropriate grounds for processing personal data related to the collection of information via Facebook Pixel. Therefore, USP Zdrowie provides users with the opportunity to voluntarily consent to the collection and use of their data for marketing purposes on the websites, in particular for the purpose of conducting marketing campaigns on Facebook. Facebook Ireland Limited provides appropriate legal grounds relating to the possibility of using the personal data of portal users for the purposes of conducting USP Zdrowie marketing activities.
  4. As part of this Privacy Policy, USP Zdrowie provides you with access to all information related to the principles of data processing as part of our business activities. Information related to the principles of personal data processing by Facebook Ireland Limited, determination of the legal basis for such processing and the methods of exercising your rights by Facebook Ireland Limited, including information on the relevant Facebook contact forms, can be found in the Data Policy available at: https://www.facebook.com/about/privacy.
  5. USP Zdrowie is responsible to the users of Internet Services for the correct operation of the mechanisms enabling obtaining and withdrawing consents to use the information collected through the Facebook Pixel tool. After receiving the data collected via Facebook Pixel, Facebook Ireland Limited is independently responsible for the rights specified in Art. 15 - 20 GDPR towards users of your social network.
  6. Both USP Zdrowie and Facebook Ireland Limited provide the possibility of exercising the right to object. in the event of receipt of a request related to an objection to the processing of personal data, USP Zdrowie and Facebook Ireland Limited will take appropriate steps regarding the further processing of their users' data.
  7. USP Zdrowie is responsible for the proper implementation and configuration of Facebook Pixel. Facebook Ireland Limited remains responsible for ensuring the security of the service offered to us and personal data processed as part of Facebook Pixel.
  8. USP Zdrowie and Facebook Ireland Limited remain responsible for the proper response to all identified data breaches. The responsibility of USP Zdrowie in connection with the use of Facebook Pixel services applies to all cases related to providing users with a properly implemented and configured tool. Facebook Ireland Limited is responsible for all data protection breaches related to processing operations performed as part of the marketing service provided to us.
LinkedIn Insight Tag short code in Java Script technology that supports conversion tracking, website audience and site demographics for LinkedIn advertising campaigns. The operation of this tool enables us to run more effective advertising campaigns and provide you with content that may be of real interest to you. The LinkedIn Insight Tag is provided and operated by LinkedIn Ireland Unlimited Company. More information on the rules for the processing of personal data with the processing of personal data by LinkedIn can be found here: https://www.linkedin.com/help/lms/answer/65513/add-the-linkedin-insight-tag-to-your-website?lang=en
Google Ads tool that is one of the elements of the Google advertising system, allowing the display of sponsored links in the search results of the Google Search Engine and on websites of entities cooperating with Google. The Google Ads tool is provided and operated by Google Ireland Limited. More information on the principles of personal data processing by Google can be found here: https://policies.google.com/privacy?hl=en
SALESmanago tool enabling the identification and monitoring of contacts and users on websites and conducting personalized marketing communication. The SALESmanago tool is provided and operated by our partner, Benhauer Sp. z o.o. More information on the principles of personal data processing using the SALESmanago tool can be found here: https://www.salesmanago.pl/marketing-automation/technologie.htm
AppNexus / Xaxis Turbine Xaxis is a global digital media platform that programmatically connects advertisers with audiences. More information on the principles of personal data processing using the Xaxis Turbine tool can be found here: https://www.xaxis.com/privacy-notice/polityka-prywatnosci-xaxis/
Selectivv tool enabling user data segmentation, used to target emissions as part of an advertising campaign. More about the rules on the site: https://selectivv.com/polityka-prywatnosci/
Campaign Manager 360 system for managing advertisements and measuring their effectiveness, designed for advertisers and media agencies. It is part of the Google Marketing Platform provided and operated by Google Ireland Limited. More information on the principles of personal data processing by Google can be found here: https://policies.google.com/privacy?hl=pl
Revhunter A tool that allows you to send advertisements to users of the Administrator's website in the form of e-mail messages that are tailored to the user's actions and behavior on the website. The retargeting service is performed via the Revhunter tool, which belongs to INIS sp. z o.o. with headquarters in Rybnik at Raciborska 35a street, Poland (TAX ID: 6423128785). More info on page: https://revhunter.pl/polityka-prywatnosci
CAKE cloud-based tool that enables campaign management, optimization and monitoring of partners in the area of performance marketing. More information here: https://getcake.com/privacy-policy/
User.com tool enabling identification and monitoring of contacts and users on websites and conducting personalized marketing communication. The User.com tool is provided and operated by our partner, User.com Sp. z o.o. More information on the principles of personal data processing using the User.com tool can be found here: https://user.com/en/privacy-policy/
Make.com is a tool for automating business processes, enabling integrations with other systems, analyzing user behavior on websites, and delivering personalized content and experiences. Make.com is provided and supported by Make.com Inc. You can find more information about the personal data processing policies using the Make.com tool here: https://www.make.com/en/privacy-notice
TikTok Pixel TikTok Pixel - A tool to integrate with your website that allows you to share website events with TikTok. When used with TikTok for Business tools, the Pixel can measure website traffic, assess the effectiveness of ad campaigns, optimize campaigns, and acquire new customers. Once properly set up and verified, the Pixel conveys information about actions taken on your site according to the events you have configured, which reflect the entire customer journey from viewing a product details page to adding an item to a cart and making a purchase. The Pixel collects data available via standard web browsers, including information about ads or events, timestamps, IP addresses, device data, and cookies that support the measurement, optimization, and targeting of your campaigns. In the future, this data will enable TikTok to customize recommendations for Pixel event settings and offer automated solutions. More information about this tool can be found in TikTok's Privacy Policy and TikTok Business Product Terms

After 5 seconds, we will refresh the page to load the current settings.