The Effect of Probiotics on the Treatment of Functional Constipation in Children of 4–12 Years of Age

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Pediatrics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran

2 Assistant Professor, Department of Social Medicine, School of Medicine AND Gastroenterology and Liver Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran

3 Resident, Department of Pediatrics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran

Abstract

Background: Functional constipation in childhood is a common and frustrating problem and probiotics are increasingly used in the treatment of functional gastrointestinal disorders. This study investigated the effect of probiotics on the treatment of functional constipation in children of 4 to 12 years of age.Methods: This clinical trial was conducted on 4 to 12-year-old children with functional constipation, according to Rome III, who referred to the clinic of Besat Hospital in Sanandaj, Iran, in 2013. The exclusion criteria included receiving any kind of laxative during the previous 4 weeks, mental retardation, hypothyroidism, cystic fibrosis, and intestinal surgery. The sample consisted of 90 children who were randomly assigned to either the intervention or the control group. The control group received routine treatment of constipation (0.7-1.5 gr/kg Pidrolax powder daily) for 4 weeks and the intervention group received routine treatment of constipation in addition to probiotics. Patients were examined 2 and 4 weeks after the intervention. Initial assessment included the frequency of bowel movements per week, stool consistency, number of fecal incontinence per week, and abdominal pain and painful defecation. The secondary assessment consisted of successful treatment, and side effects such as diarrhea and vomiting.Findings: The results showed no statistically significant difference between the two groups before and 2 and 4 weeks after the intervention in terms of the frequency of painful and difficult defecation in (P > 0.05). Nevertheless, there was a statistically significant difference between the two groups in terms of abdominal pain in 2 and 4 weeks after the intervention (P < 0.05).Conclusion: The results show that probiotics have no side effects; thus, their addition to standard therapy can be useful in children with functional constipation.

Keywords


  1. van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol 2006; 101(10): 2401-9.
  2. Kliegman RM, Stanton BMD, Geme JS, Schor NF, Behrman RE. Nelson textbook of pediatrics. 19th ed. Philadelphia, PA: Saunders; 2011. p. 1246-7.
  3. Bekkali NL, Bongers ME, van den Berg MM, Liem O, Benninga MA. The role of a probiotics mixture in the treatment of childhood constipation: a pilot study. Nutr J 2007; 6: 17.
  4. Kligler B, Cohrssen A. Probiotics. Am Fam Physician 2008; 78(9): 1073-8.
  5. Gill H, Prasad J. Probiotics, immunomodulation, and health benefits. Adv Exp Med Biol 2008; 606: 423-54.
  6. Salminen MK, Rautelin H, Tynkkynen S, Poussa T, Saxelin M, Valtonen V, et al. Lactobacillus bacteremia, clinical significance, and patient outcome, with special focus on probiotic L. rhamnosus GG. Clin Infect Dis 2004; 38(1): 62-9.
  7. Tannock GW, Munro K, Harmsen HJ, Welling GW, Smart J, Gopal PK. Analysis of the fecal microflora of human subjects consuming a probiotic product containing Lactobacillus rhamnosus DR20. Appl Environ Microbiol 2000; 66(6): 2578-88.
  8. Coccorullo P, Strisciuglio C, Martinelli M, Miele E, Greco L, Staiano A. Lactobacillus reuteri (DSM 17938) in infants with functional chronic constipation: a double-blind, randomized, placebo-controlled study. J Pediatr 2010; 157(4): 598-602.
  9. Guerra PV, Lima LN, Souza TC, Mazochi V, Penna FJ, Silva AM, et al. Pediatric functional constipation treatment with Bifidobacterium-containing yogurt: a crossover, double-blind, controlled trial. World J Gastroenterol 2011; 17(34): 3916-21.
  10. Khodadad A, Sabbaghian M. Role of synbiotics in the treatment of childhood constipation: a double-blind randomized placebo controlled trial. Iran J Pediatr 2010; 20(4): 387-92.
  11. Tabbers MM, de M, I, Roseboom MG, Benninga MA. Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study. Nutr J 2011; 10: 19.
  12. Banaszkiewicz A, Szajewska H. Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constipation in children: a double-blind, placebo-controlled randomized trial. J Pediatr 2005; 146(3): 364-9.
  13. Bu LN, Chang MH, Ni YH, Chen HL, Cheng CC. Lactobacillus casei rhamnosus Lcr35 in children with chronic constipation. Pediatr Int 2007; 49(4): 485-90.
  14. Saneian H, Tavakkol K, Adhamian P, Gholamrezaei A. Comparison of Lactobacillus Sporogenes plus mineral oil and mineral oil alone in the treatment of childhood functional constipation. J Res Med Sci 2013; 18(2): 85-8.
  15. Chmielewska A, Szajewska H. Systematic review of randomised controlled trials: probiotics for functional constipation. World J Gastroenterol 2010; 16(1): 69-75.