Improving an integrated approach to the treatment of functional constipation in children
DOI:
https://doi.org/10.15574/PS.2023.81.87Keywords:
constipation, phytocylinders, lactulose, treatment, dyspepsia, correction, childrenAbstract
Functional constipation in children has become a serious medical issue that needs to be addressed immediately. They can significantly limit children’s physical activity and social integration, which emphasizes the importance of providing them with effective care.
Purpose - to analyze and improve the results of the complex use of a lactulose-based drug and prophylactic phytocylinders with a lipophilic complex of rose hips and chamomile extract in the treatment of functional constipation in children.
Materials and methods. We examined 78 children with constipation over the past 3 years. They were divided into two groups. The first group included 36 (46.2%) patients, the second - 42 (53.8%). Patients of the first group received standard treatment according to the protocols of the Ministry of Health of Ukraine, patients of the second group received similar treatment and additionally lactulose in the form of syrup and a preparation based on prophylactic phytocylinders with a lipophilic complex of rose hips and chamomile extract during the course of treatment daily in the form of rectal suppositories.
Results. Most patients were female (60.2%), had average physical development parameters. The duration of constipation ranged from 1 to 3 months, and stool retention - from 3 to 5 days. At the beginning of the observation, there were complaints of changes in the shape and consistency of stools, painful defecation, flatulence, periodic abdominal pain, strong straining during defecation, fear or anxiety in children before the act of defecation. An analysis of anamnestic data showed that in one third of patients, constipation was observed during the transition from breastfeeding to artificial feeding.
Conclusions. The analysis of the addition to the complex of treatment of functional constipation, in addition to lactulose, of preparations based on prophylactic phytocylinders with a lipophilic complex of rose hips and chamomile extract is a safe and quite effective method of correcting these disorders in young children, as evidenced by the results obtained.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Attaluri A, Jackson M, Valestin J, Rao SS. (2010). Methanogenic flora is associated with altered colonic transit but not stool characteristics in constipation without IBS. Am J Gastroenterol. 105(6): 1407-1411. https://doi.org/10.1038/ajg.2009.655; PMid:19953090 PMCid:PMC3822765
Barbara G, Barbaro MR, Marasco G, Cremon C. (2023). Chronic constipation: from pathophysiology to management. Minerva Gastroenterol (Torino). 69(2): 277-290. https://doi.org/10.23736/S2724-5985.22.03335-6; PMid:36727654
Benninga MA, Faure C, Hyman PE, St James Roberts I, Schechter NL, Nurko S. (2016). Childhood Functional Gastrointestinal Disorders: Neonate/Toddler Gastroenterology. S0016-5085(16)00182-7. https://doi.org/10.1053/j.gastro.2016.02.016; PMid:27144631
Dias FC, Melli LCFL, Boilesen SN, Tahan S, Morais MB. (2023). Hypohydration, Functional Constipation, and Physical Activity in Elementary School Students. J Pediatr Gastroenterol Nutr. 77(2): 203-206. https://doi.org/10.1097/MPG.0000000000003808; PMid:37669329
García-Santos JA, Nieto-Ruiz A, García-Ricobaraza M, Cerdó T, Campoy C. (2023). Impact of Probiotics on the Prevention and Treatment of Gastrointestinal Diseases in the Pediatric Population. Int J Mol Sci. 24(11): 9427. Published 2023 May 29. https://doi.org/10.3390/ijms24119427; PMid:37298377 PMCid:PMC10253478
Ginton L, Nurko S, Di Lorenzo C, Saps M. (2023). First study to assess the reliability of commonly used pain scales in children with disorders of gut-brain interaction. Neurogastroenterol Motil. 35(9):e14636. https://doi.org/10.1111/nmo.14636; PMid:37448182
Gou HZ, Zhang YL, Ren LF, Li ZJ, Zhang L. (2022). How do intestinal probiotics restore the intestinal barrier? Front Microbiol. 13: 929346. Published 2022 Jul 14. https://doi.org/10.3389/fmicb.2022.929346; PMid:35910620 PMCid:PMC9330398
Gray JR. (2011). What is chronic constipation? Definition and diagnosis. Can J Gastroenterol. 25; Suppl B: 7B-10B. https://doi.org/10.1155/2011/593056
Heidelbaugh J, Martinez de Andino N, Pineles D, Poppers DM. (2021). Diagnosing Constipation Spectrum Disorders in a Primary Care Setting. J Clin Med. 10(5): 1092. Published 2021 Mar 5. https://doi.org/10.3390/jcm10051092; PMid:33807888 PMCid:PMC7961346
Jani B, Marsicano E. (2018). Constipation: Evaluation and Management. Mo Med. 115(3): 236-240.
Krycky ІO, Hoshchynskyi PV, Dzhyvak VG, Protsailo MD, Badiuk NS. (2021). Application of phytocylinders with lipophilic complex of rosa canina and chamomile extract for treatment of constipation in pediatric surgery practice. Pharmacologyonline. 3: 1103-1106.
Leung AK, Hon KL. (2021). Paediatrics: how to manage functional constipation. Drugs Context. 10: 2020-11-2. https://doi.org/10.7573/dic.2020-11-2; PMid:33828605 PMCid:PMC8007206
Lewis SJ, Heaton KW. (1997). Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 32(9):920-924. https://doi.org/10.3109/00365529709011203; PMid:9299672
Ma J, Ma H, Zheng S et al. (2023). Intestinal flora in the constipation patients before versus after lactulose intervention. Medicine (Baltimore). 102(32): e34703. https://doi.org/10.1097/MD.0000000000034703; PMid:37565923 PMCid:PMC10419342
MOZ Ukrainy. (2013). Pro zatverdzhennia unifikovanykh klinichnykh protokoliv medychnoi dopomohy ditiam iz zakhvoriuvanniamy orhaniv travlennia. Nakaz MOZ Ukrainy vid 29.01.2013 r. No. 59. URL: https://zakon.rada.gov.ua/rada/show/v0059282-13#Text.
Neves RO, Nunes LM, Silveira LO, Lima MR, Moreira PR, Bernardi JR. (2023). Functional constipation symptoms and complementary feeding methods: A randomized clinical trial. An Pediatr (Engl Ed). 98(4): 267-275. https://doi.org/10.1016/j.anpede.2023.01.011; PMid:36922244
Panesar PS, Kumari S. (2011). Lactulose: production, purification and potential applications. Biotechnol Adv. 29(6): 940-948. https://doi.org/10.1016/j.biotechadv.2011.08.008; PMid:21856402
Prytula VP, Kurtash OO, Hussaini SF, Rusak PS, Petryk SM. (2022). Reconstructive-plastic operations for restoring patency at different levels of subtotal resection of the colon in children with intestinal agangliosis. Paediatric Surgery (Ukraine). 1(74): 45-55. https://doi.org/10.15574/PS.2022.74.45
Rao SSC, Lacy BE, Emmanuel A et al. (2022). Recognizing and Defining Occasional Constipation: Expert Consensus Recommendations. Am J Gastroenterol. 117(11): 1753-1758. https://doi.org/10.14309/ajg.0000000000001945; PMid:35971230
Rybalchenko VV. (2015). Syndrom zakrepiv u ditei. Navchalnyi posibnyk. Za red. V.V. Berezhnoho, P.S. Rusaka, Hrony. Kyiv: TOV «VIT-A-POL»: 234.
Shadrin OH, Diukareva SV, Cherneha NF. (2007). Alimentarna korektsiia funktsionalnykh zakrepiv u ditei rannoho viku. Suchasna pediatriia. 3(16): 101-103.
Shin JE, Park KS, Nam K. (2019). Chronic Functional Constipation. Korean J Gastroenterol. 73(2): 92-98. https://doi.org/10.4166/kjg.2019.73.2.92; PMid:30845385
Tran DL, Sintusek P. (2023). Functional constipation in children: What physicians should know. World J Gastroenterol. 29(8): 1261-1288. https://doi.org/10.3748/wjg.v29.i8.1261; PMid:36925458 PMCid:PMC10011959
Vinelli V, Biscotti P, Martini D et al. (2022). Effects of Dietary Fibers on Short-Chain Fatty Acids and Gut Microbiota Composition in Healthy Adults: A Systematic Review. Nutrients. 14(13): 2559. https://doi.org/10.3390/nu14132559; PMid:35807739 PMCid:PMC9268559
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