@article{article_619141, title={Treatment of Childhood Functional Constipation: Comparison of Senna, Trimebutine and Lactulose}, journal={Türkiye Çocuk Hastalıkları Dergisi}, volume={14}, pages={295–301}, year={2020}, DOI={10.12956/tchd.619141}, author={Demir, Arzu Meltem and Kuloğlu, Zarife and Kansu, Aydan}, keywords={Kabızlık,Laktüloz,Senna,Trimebutin}, abstract={<p class="MsoNormal" style="text-align:justify;line-height:200%;"> <b> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">Objective: </span> </b> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">
Childhood constipation is common and usually functional. Data for the drugs
used in maintenance therapy of functional constipation is limited in childhood.
Our aim was <span style="letter-spacing:-.5pt;">to </span>evaluate the efficacy
of senna, trimebutine and lactulose in children with functional constipation
(FC) or functional fecal incontinence (FFI). </span> </p> <p> </p> <p class="MsoNormal" style="text-align:justify;line-height:200%;"> <b> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">Material and Methods: </span> </b> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">Patients  (2-18 years old) diagnosed as FC or FFI according
to Rome III criteria who were treated with lactulose (n=36), senna (n=29) and
trimebutine (n=33)were included. Patients completed a 0-5 Likert scale
questionnaire about their symptoms. Stool consistency (SC) was evaluated by
Bristol Stool Chart. Compliance and tolerance to treatment and side effects
were recorded. C <span class="hps">linical improvement </span> (CI) and p <span class="hps">harmacoeconomic </span> evaluation <span class="hps">were performed </span> <i>. </i> </span> </p> <p> </p> <p class="MsoNormal" style="text-align:justify;line-height:200%;"> <span class="hps"> <b> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">Results: </span> </b> </span> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">CI
in the senna group was significantly higher (p=0.036). Senna showed the highest
improvement in SC (p<0.001) and decreased fecal incontinence (p=0.039).
Abdominal distention, abdominal pain, nausea/vomiting and anal fissure were
improved by trimebutine (p<0.05). Both senna and trimebutine decreased
painful defecation and stool witholding. Lactulose improved anorexia and anal
fissure. Senna was the most cost-effective drug. <b>Conclusion: </b>Treatment options for constipation should be tailored
according to the predominant symptom. </span> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">Senna may be recommended as the
initial treatment for children with obesity and/or fecal incontinence, </span> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">t </span> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">rimebutine
in patients with a </span> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;">bdominal distention,  abdominal pain,  nausea/vomiting or anal fissure, lactulose in
patients with anorexia or anal fissure, respectively. </span> </p> <p> </p> <br /> <p> </p> <p class="MsoNormal" style="text-align:justify;line-height:200%;"> <b> <span style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;"> </span> </b> </p> <p> <b>  </b> </p> <b> </b> <p class="MsoNormal" style="text-align:justify;line-height:200%;"> <br /> </p>}, number={4}, publisher={T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi}