A Dietary Fiber Mixture versus Lactulose in the Treatment of Childhood Constipation: A Double‐blind Randomized Controlled Trial

Kokke, Freddy; Scholtens, Petra A. M. J.; Alles, M.S.; Decates, Tom; Fiselier, T.J.W.; Tolboom, J.J.M.; Kimpen, Jan L. L.; Benninga, Marc A.

doi:10.1097/mpg.0b013e318162c43c

Cited by 83 publications

(69 citation statements)

References 32 publications

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“…No RCTs on the effects of physical movement, multidisciplinary treatment, or alternative medicine (acupuncture, homeopathy, mind-body therapy, musculoskeletal manipulations such as osteopathic and chiropractic manipulations, or spiritual therapies such as yoga) for children with constipation were found. All studies were hospital-based; 3 were conducted in a general pediatric department 14,18,19 and 6 were conducted in a pediatric gastroenterology department. [11][12][13][15][16][17] The studies were highly diverse with regard to the participants, interventions, and outcome measures; therefore, a meta-analysis of all included studies could not be performed.…”

Section: Study Selection and Methodologic Quality Assessmentmentioning

confidence: 99%

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Nonpharmacologic Treatments for Childhood Constipation: Systematic Review

Tabbers¹,

Boluyt

Berger³

et al. 2011

Pediatrics

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OBJECTIVE:To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine. METHODS:We systematically searched 3 major electronic databases and reference lists of existing reviews. We included systematic reviews and randomized controlled trials (RCTs) that reported on nonpharmacologic treatments. Two reviewers rated the methodologic quality independently. RESULTS:We included 9 studies with 640 children. Considerable heterogeneity across studies precluded meta-analysis. We found no RCTs for physical movement, multidisciplinary treatment, or alternative medicine. Some evidence shows that fiber may be more effective than placebo in improving both the frequency and consistency of stools and in reducing abdominal pain. Compared with normal fluid intake, we found no evidence that water intake increases or that hyperosmolar fluid treatment is more effective in increasing stool frequency or decreasing difficulty in passing stools. We found no evidence to recommend the use of prebiotics or probiotics. Behavioral therapy with laxatives is not more effective than laxatives alone. CONCLUSIONS:There is some evidence that fiber supplements are more effective than placebo. No evidence for any effect was found for fluid supplements, prebiotics, probiotics, or behavioral intervention. There is a lack of well-designed RCTs of high quality concerning nonpharmacologic treatments for children with functional constipation.

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Section: Study Selection and Methodologic Quality Assessmentmentioning

confidence: 99%

“…14 The study used an adequate randomization procedure, but no information on blinding of the outcome assessor was provided, no intention-to-treat analysis was performed, and the dropout rate was high and not equally distributed. Polyethylene glycol (macrogol 3350) was added if no clinical improvement was observed after 3 weeks.…”

Section: Fiber Versus Lactulosementioning

confidence: 99%

Nonpharmacologic Treatments for Childhood Constipation: Systematic Review

Tabbers¹,

Boluyt

Berger³

et al. 2011

Pediatrics

View full text Add to dashboard Cite

show abstract

“…The necessity of step-up medication during the treatment period was comparable (P=0.996). Authors concluded that the fluid fibre mixture and lactulose gave comparable results in the treatment of childhood constipation 4 .…”

Section: Dietary Fibre and Childhood Constipationmentioning

confidence: 99%

“…Using a standardized bowel diary, parents recorded defaecation frequency during the treatment period. In addition, incontinence frequency, stool consistency, presence of abdominal pain and flatulence, necessity for step-up medication, and dry weight of faeces were recorded 4 . Of the 135 participants, 65 were randomized to treatment with fibre mixture and 70 to treatment with lactulose.…”

Section: Dietary Fibre and Childhood Constipationmentioning

confidence: 99%