Are Constipated Children Different from Constipated Adults?

Solzi, Gabriel F.; Lorenzo, Carlo Di

doi:10.1159/000016956

Cited by 18 publications

(8 citation statements)

References 39 publications

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“…Vasconcelos et al [20] undertook urinary reeducation in 55 children with LUTD refractory to conventional treatment. Of these, 66% were girls, reinforcing the observations of a higher prevalence of LUTD among girls, as is described in the literature [21][22][23].…”

Section: Discussionsupporting

confidence: 75%

Prevalence of lower urinary tract symptoms in school-age children

et al. 2011

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Epidemiological studies have demonstrated rates of incontinence and enuresis as high as 20% in school-age children. This cross-sectional study aimed to investigate the prevalence of lower urinary tract (LUT) symptoms in 739 children aged 6-12 years enrolled in three government schools with different socioeconomic levels in Minas Gerais, Brazil. Symptoms of LUT were evaluated using a modified version of the Dysfunction Voiding Scoring System in which the cutoff point considered as an indicator of LUT dysfunction is >6 for girls and >9 for boys. Children with a score indicative of symptoms received an educational booklet on the functioning of the LUT and were sent for clinical evaluation. LUT dysfunction symptoms were detected in 161 (21.8%) children. Symptoms were most frequent in girls (p < 0.001), children aged 6-8 (p < 0.028), and attended the school with the lowest social level (p < 0.001). Intestinal constipation was the most prevalent finding (30.7%), independent of LUT score. The most common urinary symptoms in children with an elevated score were diurnal urinary incontinence (30.7%), holding maneuvers (19.1%), and urinary urgency (13.7%). Stress factors were associated in 28.4% of children. Our findings suggest that LUT symptoms must be investigated carefully at routine pediatric visits.

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Section: Discussionsupporting

confidence: 75%

Prevalence of lower urinary tract symptoms in school-age children

et al. 2011

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“…9 The difference in efficacy of the fermented dairy product that contains B lactis DN-173 010 between adults and children underscores the hypothesis that constipation in children differs considerably from that in constipated adults with regard to its prevalence, onset, etiology, symptoms, treatment, and prognosis. 22 We found in the control group a higher rate of success than expected, namely 24% instead of 15%. In an earlier study by Nurko et al 23 conducted in children with functional constipation, a response rate of 40% was found in the placebo group.…”

Section: Discussioncontrasting

confidence: 57%

Fermented Milk Containing Bifidobacterium lactis DN-173 010 in Childhood Constipation: A Randomized, Double-Blind, Controlled Trial

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Chronic constipation is a common problem in childhood. In two randomized trials in adults with irritable bowel syndrome and constipation, and 1 in constipated women with a defecation frequency Ͻ3 times per week, a significant increase was shown in stool frequency in the probiotic group who used Bifidobacterium lactis DN-173 010 compared with the control group in subjects who had Ͻ3 stools per week. WHAT THIS STUDY ADDS:In constipated children, the fermented dairy product that contained B lactis strain DN-173 010 increased stool frequency, but this increase was comparable to that of the control group. There is currently insufficient evidence to recommend fermented dairy products that contain B lactis strain DN-173 010 for these patients. abstract BACKGROUND: Constipation is a frustrating symptom affecting 3% of children worldwide. A fermented dairy product containing Bifidobacterium lactis strain DN-173 010 was effective in increasing stool frequency in constipated women. Our aim was to assess the effects of this product in constipated children. METHODS: In this prospective randomized, double-blind, controlled trial, 159 constipated children (defecation frequency Ͻ 3 times per week) were randomly allocated to receive either a fermented dairy product that contains B lactis DN-173 010 (n ϭ 79) or a control product (n ϭ 80) twice a day for 3 weeks. The primary endpoint was the change in stool frequency from baseline to after 3 weeks of product consumption. Analyses were by intention to treat. RESULTS: Eleven children did not return to any follow-up visit (5 in the probiotic group, 6 in the control group) and were therefore excluded from the final analysis. Thus, 74 children in each group were analyzed. The change in stool frequency from baseline to after 3 weeks of product consumption increased in both groups, but the difference was not statistically significant (2.9 Ϯ 3.2 in probiotic group versus 2.6 Ϯ 2.6 in control group, P ϭ .35). There were no serious adverse events. CONCLUSIONS: In constipated children, the fermented dairy product containing B lactis strain DN-173 010 did increase stool frequency, but this increase was comparable in the control group. There is currently not sufficient evidence to recommend fermented dairy products containing B lactis strain DN-173 010 in this category of patients. Future studies should focus on whether a longer period of probiotic products is more effective in children who have a short history of constipation.

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“…All studies showed an increased defecation frequency and improved stool consistency [20]. These findings, however are not directly applicable to the paediatric population because constipation in children differs considerably from that in constipated adults with regard to its prevalence, onset, aetiology, symptoms, treatment, and prognosis [21]. …”

Section: Discussionmentioning

confidence: 99%

Is Bifidobacterium breveeffective in the treatment of childhood constipation? Results from a pilot study

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Roseboom

et al. 2011

Nutr J

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BackgroundProbiotics are increasingly used in the treatment of functional gastrointestinal disorders. Studies in constipated adults with a Bifidus yoghurt (containing Bifidobacterium breve, Bifidobacterium bifidum and Lactobacillus acidophilus) showed a significant increase in defecation frequency. The aim of this pilot study was to determine if Bifidobacterium breve is effective in the treatment of childhood constipation.MethodsChildren, 3 to 16 years of age, with functional constipation according to the Rome III criteria were eligible for this study. During 4 weeks, children received one sachet of powder daily, containing 108- 1010 CFU Bifidobacterium breve. Furthermore, children were instructed to try to defecate on the toilet for 5-10 minutes after each meal and to complete a standardized bowel diary daily. The primary outcome measure was change in defecation frequency. Secondary outcome measures were stool consistency using the Bristol stool scale frequency of episodes of faecal incontinence, pain during defecation, frequency of abdominal pain, frequency of adverse effects (nausea, diarrhoea and bad taste), and frequency of intake of bisacodyl.ResultsTwenty children (75% male, mean age 7.4) were included in this pilot study. The defecation frequency per week significantly increased from 0.9 (0-2) at baseline to 4.9 (0-21) in week 4 (p < 0.01). The mean stool consistency score increased from 2.6 (2-4) at baseline to 3.5 (1-6) in week 4 (p = 0.03). The number of faecal incontinence episodes per week significantly decreased from 9.0 (0-35) at baseline to 1.5 (0-7) in week 4 (p < 0.01). Abdominal pain episodes per week significantly decreased from 4.2 (0-7) at baseline to 1.9 (0-7) in week 4 (p = 0.01). No side effects occurred.ConclusionBifidobacterium breve is effective in increasing stool frequency in children with functional constipation. Furthermore it has a positive effect with respect to stool consistency, decreasing the number of faecal incontinence episodes and in diminishing abdominal pain. A randomized placebo controlled trial is required to confirm these data.

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Are Constipated Children Different from Constipated Adults?

Cited by 18 publications

References 39 publications

Prevalence of lower urinary tract symptoms in school-age children

Prevalence of lower urinary tract symptoms in school-age children

Fermented Milk Containing Bifidobacterium lactis DN-173 010 in Childhood Constipation: A Randomized, Double-Blind, Controlled Trial

Is Bifidobacterium breveeffective in the treatment of childhood constipation? Results from a pilot study

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