Selenium and functional constipation in children

Main Article Content

Marlina Tanjung
Supriatmo Supriatmo
Melda Deliana
Ade Rachmat Yudiyanto
Atan Baas Sinuhaji


Background Constipation is a common problem in children, with approximately 90 to 95% of constipation cases having functional constipation. Oxidative stress may be a causative factor in gastrointestinal diseases, alleved by intervention with antioxidants. Selenium is an essential trace element and acts as a cofactor of gluthathione peroxidase, which protects membranes from oxidative damage.
Objective To determine the effect of selenium on functional constipation in children.
Methods We conducted a single-blind, randomized clinical trial from November to December 2012 at the Al-Kautsar Al-Akbar Islamic Boarding School in Medan, North Sumatra. Subjects were children aged 12 to 17 years with functional constipation, diagnosed according to the ROME III criteria. Patients were randomly allocated into either the selenium group (n=57) or the placebo group (n=57). Subjects were clinically evaluated for frequency of defecation, stool consistency, severity of abdominal pain, and side effects during the 2 weeks of treatment (days 7 and 14) and 1 week after treatment had stopped (day 21).
Results A total of 114 subjects were eligible to participate. The average frequency of defecation observed on day 14 was 1.5 (SD 0.75) days per defecation (P=0.0001) in the selenium group and 2.4 (0.84) days per defecation in the placebo group, a statistically significant difference (P=0.0001). There was no significant difference in frequency of defecation on the 7th day of treatment. But after day 7, there were significant differences between the groups at days 14 and 21. Normal stool consistency was found in 45 subjects (78.9%) on day 7 and in 57 subjects (100%) on day 14 of treatment in the selenium group, significantly more than those in the placebo group (P<0.05). In placebo group, normal stool consistency was found in 27 subject (47.4%) with (P=0.001) on day 7 and in 38 subject (66.7%) on day 14 of treatment (P=0.0001). On day 14, the selenium group had significantly more subjects without pain than the placebo group [47 subjects (82.5%) vs. 10 subjects (17.5%), respectively (P=0.0001)]. Severity of abdominal pain after 14th day of treatment is without pain 47 subject (82.5%) and mild pain 10 subject (17.5%) (P=0.0001). We found no side effects of selenium treatment in our subjects.

Conclusion Selenium is effective in improving clinically functional constipation, in terms of increased frequency of defecation, normalization of stool consistency, and less severe abdominal pain.

Article Details

How to Cite
Tanjung M, Supriatmo S, Deliana M, Yudiyanto AR, Sinuhaji AB. Selenium and functional constipation in children. PI [Internet]. 19Jul.2016 [cited 18Oct.2019];56(2):111-. Available from:
Pediatric Gastrohepatology
Received 2016-07-19
Accepted 2016-07-19
Published 2016-07-19


1. Bhardwaj P. Oxidative stress and antioxidants in gastrointestinal diseases. Trop Gastroenterol. 2008;29:129-35.
2. Hidajat Boerhan. Penggunaan antioksidan pada anak. Kapita Selekta Ilmu Kesehatan Anak IV “Hot topic in pediatrics”. Continuing Education Ilmu Kesehatan Anak XXXV. 2005 Sept 3-4; Surabaya.
3. Wang JY, Wang YL, Zhou SL, Zhou JF. May chronic childhood constipation cause oxidatve stress and potential free radical damage to children? Biomed Environ Sci. 2004;17:266-72.
4. Zhou JF, Lou JG, Zhou SL, Wang JY. Potential oxidative stress in children with chronic constipation. World J Gastroenterol. 2005;11:368-71.
5. Firmansyah A. Konstipasi pada anak. In: Jufri M, Soenarto YS, Oswari H, Arief S, Rosalina I, Mulyani SN, editors. Gastroenterologi-hepatologi. 1st ed. Jakarta: IDAI; 2010. p. 201-14.
6. Fan AM, Kizer KW. Selenium. Nutritional, toxicologic, and clinical aspects. West J Med. 1990;153:160-7.
7. Schwarz K, Foltz CM. Selenium as an integral part of factor 3 against dietary necrotic liver degeneration. J Am Chem Soc. 1957;79:3292-3.
8. Akcam M. Helicobacter pylori and micronutrients. Indian Pediatr. 2010;47:119-26.
9. Jiang X, Dong J, Wang B, Yin X, Qin L. Effects of organic selenium supplement on glutathione peroxidase activities: a meta-analysis of randomized controlled trials. Wei Sheng Yen Jiu. 2012;41:120-3.
10. Burger R, Levin AD, Di Lorenzo C, Dijkgraaf MG, Benninga MA. Functional defecation disordersin children : comparing the Rome II with the Rome III criteria. J Pediatr. 2012;161:615-20.
11. Wald A, Sigurdsson L. Quality of life in children and adults with constipation. Best Pract Res Clin Gastroenterol. 2011;25:19–27.
12. Saps M, Sztainberg M, Di Lorenzo C. A prospective community-based study of gastroenterological symptoms in school-age children. J Pediatr Gastroenterol Nutr. 2006;43:477-82.
13. Mugie SM, Benninga MA, Di Lorenzo C. Epidemiology of constipation in children and adults: a systematic review. Best Pract Res Clin Gastroenterol. 2011;25:3–18.
14. Loening-Baucke V. Prevalence rates for constipation and faecal and urinary incontinence. Arch Dis Child. 2007;92:486-9.
15. Lee WT, Ip KS, Chan JS, Lui NW, Youn BW. Increased prevalence of constipation in pre-school children is attributable to under-consumption of plant foods: a community-based study. J Paediatr Child Health. 2008;44:170-5.
16. Peeters B, Benninga MA, Hennekam RC. Childhood constipation; an overview of genetic studies and associated syndromes. Best Pract Res Clin Gastroenterol. 2011;25:73–88.
17. American Gastroenterology Association. American Gastroenterological Association Technical Review on Constipation. Gastroenterology. 2013;144:218-38.
18. Richmond JP, Wright ME. Development of a constipation risk assessment scale. J Ortho Nurs. 2006;10:186–97.
19. Misra S, Lee A, Gensel K. Chronic constipation in overweight children. J Parenter Enteral Nutr. 2006;30:81-4.
20. Fishman L, Lenders C, Fortunato C, Noonan C, Nurko S. Increased prevalence of constipation and fecal soiling in a population of obese children. J Pediatr. 2004;145:253-4.
21. Prasetyo D. Konstipasi pada anak. Proceedings of the Kongres Nasional IV Badan Koordinasi Gastroenterologi Indonesia (BKGAI); 2010 Dec 4-7; Medan: BKGAI; 2010. p. 55-63.
22. Clayden G, Keshtgar AS. Management of childhood constipation. Postgrad Med J. 2003; 79:616-21.
23. Tabbers MM, Boluyt N, Berger MY, Benninga MA. Clinical practice: diagnosis and treatment of functional constipation. Eur J Pediatr. 2011;170:955-63.
24. Thomson CD. Assesment of requirement for selenium and adequacy of selenium status : a review. Eur J Of Clin Nutr.2004;58:391-402.
25. Litov R, Combs GF. Selenium in pediatric nutrition. Pediatrics 1991;87:339-49.
26. Naftali T, Feingelernt H, Lesin Y, Rauchwarger A, Konikoff FM. Ziziphus jujuba extract for the treatment of chronic idiopathic constipation: a controlled clinical trial. Digestion. 2008;78:224-8.
27. Chambers CT, Giesbrecht K, Craig KD, Bennett SM, Huntsman E. A comparison of faces scales for the measurement of pediatric pain: children’s and parents’ ratings. Pain. 1999;83:25-35.
28. Garra G, Singer AJ, Domingo A, Thode HC. The Wong-Baker pain FACES Scale measures pain, not fear. Pediatr Emerg Care. 2013;29:17-20.
29. Dwipoerwantoro PG. Perubahan mekanisme stress oksidatif pada tikus dengan defisiensi selenium dan pengaruh defisiensi selenium pada kadar hormon tiroid plasma. Ringkasan [disertasi]. [Jakarta]: Universitas Indonesia; 2009.