Effectiveness of synbiotics as laxative agent for constipation in children
Keywords:
constipation, child, synbiotics, laxative agent
Abstract
Background Constipation in children can cause serious problems.Laxative is needed for the management of constipation. Oral
laxative has been used frequently, even though a safe oral laxative
agents for children is limited. Prebiotic and probiotic have already
been proven to have laxative effect in constipation in children and
adults. The effectiveness of these agents as a laxative has not been
proven yet.
Objective To evaluate the effectiveness of laxative synbiotic in
constipation in children compared to that of fiber foods.
Methods A randomized double blind controlled trial was
conducted on children aged 6 months-14 years old who suffered
from functional constipation at Dr. Sardjito Hospital, Dr. Soeradji
Tirtonegoro Hospital, and Wates District Hospital from April2007
-October 2007. Randomization was performed by computer. The
outcome of recovery rate, onset therapy and side effects were
evaluated after seven days of intervention.
Results Forty-three children were included in this study, but only
41 could be analyzed. Subject characteristics in both groups were
comparable except for maternal educational level. The main
outcome (recovery rate) was assessed by intention to treat principle.
Compared with fiber foods, synbiotic increased the recovery rate
with RR 2.14 (95%CI 1.14; 4.02) and NNT 2.9 (95%CI 2; 15),
whereas its therapeutic onset was 15 hours faster than that of fiber
foods. No important side effects were found in both groups.
Conclusions Synbiotic is safe and effective in increasing the
recovery rate of functional constipation with faster therapeutic
onset than that of fiber foods.
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in children, pathophysiology and clinical approach. Proceedings
of the 12th National Congress of Child Health and the
11th ASEAN Pediatric Federation Conference; 2002; Bali,
Indonesia.
2. Loening-Baucke V Prevalence, symptoms and outcome of
3. Ulsben M.The digestive system. In: Behrman RE, Kliegman
constipation in infants and toddlers. J Pediatr 2005; 146:359-63.
RM, Jenson HB, editors. Nelson textbook of pediatrics. 15th
ed. Philadelphia: Saunders; 1999. p. 1034-5.
4. Johnson KB, Oski FA. Oski's essential pediatrics. 1st Ed.
5. Loening-Baucke V, Miele E, Staiano A. Fiber (glucomanan)
Philadelphia: Lippincott-Raven Publishers; 1997.
is beneficial in the treatment of childhood constipation.
Pediatrics 2004;113:259-64.
6. Savino F, Maccario S, Castagno E, Cresi F, Cavallo F, Dalmasso
P, et al. Advances in the management of digestive problems
during first months oflife. Acta Paediatr 2005;94:Sl20-4.
7. Quah HM, Ooi BS, Seow-Choen F, Sng KK, Ho KS.
Prospective randomized crossover trial comparing fibre with
lactulose in the treaUnent of idiopathic chronic constipation.
Tech Coloproctol2006; 10:111-4.
8. Cummings JH, Macfarlane GT, Englyst HN. Prebiotic digestion
and fermentation. Am] Clin Nutr 2001;73:S415-20.
9. Mitsuoka T. Intestinal flora and human health. Asia Pasific
J Clin Nutr 1996;5:2-9.
10. Washington N, Harris M, Musselwhite A, Spiller RC.
Moderation oflactulose-induced diarrhea by psillium: effect on
motility and fermentation. Am J Clin Nutr 1998;67:317-21.
11. Topping DL. Short-chain fatty acids produced by intestinal.
Asia PasificJ Clin Nutr 1996;5:S15-9.
12. Bird AR. Prebiotics: A role for dietary fibre and resistant
starch. Asia Pasific J Clin Nutr 1999;8:S32-6.
13. Arce DA, Ermocilla CA, Costa H. Evaluation of constipation.
Am Fam Physician 2002;65:2283-90.
14. Plas RN. Clinical management and treatment options
children with defecation disorder {Dissertation}. Amsterdam:
Universiteit van Amsterdam. 1998.
15. Williams CL, Bollella M, Wynder EL. A new recomendation
for dietary fiber in childhood. Pediatrics 1995;96:985-8.
16. Dwyer JT. Dietary fiber for children: how much?. Pediatrics
1995;96: 1019-22.
17. Harun SR, Putra ST, Wiharto AS, Chair I. Uji Klinis. In:
Sastroasmoro S, Ismael S, editors. Dasar-dasar metodologi
penelitian klinis. 2nd ed. Jakarta: CV Sagung Seto; 2002.
p. 144-65.
18. Bouhnik Y, Vahedi K, Achour L, Attar A, Salfati J, Pochart
P, et a!. Short-chain fructo-oligosaccharide administration
dose-dependently increases fecal bifidobacteria in healthy
humans. J Nutr 1999;129:113-6.
19. Boehm G, Lidestri M, Casetta P, Jelinek J, Negretti F,
Stahl B, et a!. Supplementation of a bovine milk formula
with an oligosaccharide mixture inreases counts of faecal
bifidobacteria in preterm infants. Arch Dis Child Fetal
Neonatal2002;86: 178 -81.
20. Boehm G. Prebiotic concept for infant nutrition. Acta Pediatr
2002;441 :64-7.
21. Guesry PR, Badanski H, Tomsit E. Effect of three doses of
fructooligosaccharides in infants. J Pediatr Gastroenterol
Nutr 2000;31:5252.
22. Mora G, Minoli L, Mosca M, Fanara S, Jelinek J, Stahl B,
et a!. Dosage-related bifidogenic effects of galacto- and
fructooligosaccharides in formula-fed term infants. J Pediatr
Gastroenterol Nutr 2002;34:291-5.
23. Stahl B, ThudS, Zeng J.Oligosaccharides from human milk
as revealed by matrix assisted Iasser desorption/ionization
mass spectrometry. Anal Biochem 1994;223:218.
24. Boyle RJ, Robins-Browne RM, LK Tang L. Probiotic use
in clinical practice: what are the risks?. Am J Clin Nutr
2006;83: 1256-64.
25. Bruno FA, Shah NP. Reviews: effects of feeding bifidobac-
terium longum and inulin on some gatrointestinal indices
in human volunteers. Biosci Microflora 2003;23: 11-20.
26. Garleb KA, Snowden MK, Wolf BW, Chow J. Application
of fructooligosaccharides to medical foods as a fermentable
dietary fiber. Biosci Microf!ora 2001;21:43-5.
Published
2016-09-26
How to Cite
1.
Hannah H, Juffrie M, Soenarto S. Effectiveness of synbiotics as laxative agent for constipation in children. PI [Internet]. 26Sep.2016 [cited 26Apr.2024];48(3):136-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/491
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Received 2016-09-07
Accepted 2016-09-07
Published 2016-09-26
Accepted 2016-09-07
Published 2016-09-26
