Nata N, Suebsiripong S, Satirapoj B, et al. - Similar efficacy of lactulose vs senna plus ispaghula husk was evident for treating constipation in pre-dialysis chronic kidney disease (CKD) patients.

• Total 22 patients with pre-dialysis CKD and constipation were randomized to receive either lactulose or senna plus ispaghula husk daily for 14 days.

• Post- 7-day washout span, patients were switched to the other substance for the next 14 days.

• Mean complete spontaneous bowel movement (CSBM) weekly increase from baseline was evident in the lactulose group and the senna plus ispaghula husk group at the close of study.

• CSBM did not differ significantly between lactulose and senna plus ispaghula husk.

• Use of ispaghula husk with senna resulted in significant change in Bristol stool form scale (BSFS); the mean ± SD of BSFS altered to 1.7 ± 1.8 (p = 0.001).

• The mean ± SD of BSFS changed to 1.6 ± 1.8 (p = 0.001) post- lactulose use.

• Serious adverse events did not occur in either group.