TY  - JOUR
T1  - Treatment of Childhood Functional Constipation: Comparison of Senna, Trimebutine and Lactulose
TT  - Çocukluk Çağında Fonksiyonel Kabızlık Tedavisi: Senna, Trimebutin ve Laktülozun Karşılaştırılması
AU  - Demir, Arzu Meltem
AU  - Kuloğlu, Zarife
AU  - Kansu, Aydan
PY  - 2020
DA  - June
DO  - 10.12956/tchd.619141
JF  - Türkiye Çocuk Hastalıkları Dergisi
JO  - Türkiye Çocuk Hast Derg
PB  - T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi
WT  - DergiPark
SN  - 1307-4490
SP  - 295
EP  - 301
VL  - 14
IS  - 4
LA  - en
AB  - Objective:Childhood constipation is common and usually functional. Data for the drugsused in maintenance therapy of functional constipation is limited in childhood.Our aim was to evaluate the efficacyof senna, trimebutine and lactulose in children with functional constipation(FC) or functional fecal incontinence (FFI). Material and Methods: Patients (2-18 years old) diagnosed as FC or FFI accordingto Rome III criteria who were treated with lactulose (n=36), senna (n=29) andtrimebutine (n=33)were included. Patients completed a 0-5 Likert scalequestionnaire about their symptoms. Stool consistency (SC) was evaluated byBristol Stool Chart. Compliance and tolerance to treatment and side effectswere recorded. Clinical improvement (CI) and pharmacoeconomic evaluation were performed.Results: CIin the senna group was significantly higher (p=0.036). Senna showed the highestimprovement in SC (p<0.001) and decreased fecal incontinence (p=0.039).Abdominal distention, abdominal pain, nausea/vomiting and anal fissure wereimproved by trimebutine (p<0.05). Both senna and trimebutine decreasedpainful defecation and stool witholding. Lactulose improved anorexia and analfissure. Senna was the most cost-effective drug. Conclusion: Treatment options for constipation should be tailoredaccording to the predominant symptom. Senna may be recommended as theinitial treatment for children with obesity and/or fecal incontinence, trimebutinein patients with abdominal distention, abdominal pain, nausea/vomiting or anal fissure, lactulose inpatients with anorexia or anal fissure, respectively.
KW  - Constipation
KW  - Lactulose
KW  - Senna
KW  - Trimebutin
N2  - Amaç:Çocukluk çağında kabızlık yaygın olup sıklıkla fonksiyoneldir. Çocuklardafonksiyonel kabızlık tedavisinde kullanılan ilaçlarla ilgili bilgilersınırlıdır. Amacımız fonksiyonel kabızlık (FK) veya fonksiyonel fekalinkontinans (FFİ) olan çocuklarda senna, trimebutin ve laktülozun etkinliğinideğerlendirmektir. Gereç ve Yöntemler:Roma III kriterlerine göre fonksiyonel kabızlık (FK) veya fonksiyonel fekalinkontinans (FFI) tanısı koyulan, laktüloz (n=36), senna (n=29) ve trimebutin(n=33) tedavisi alan hastalar (2-18 yaş) alındı. Hastalar semptomlarıyla ilgili0-5 Likert anket ölçeğini doldurdular. Dışkı kıvamı (DK) Bristol DışkıSkalasına göre değerlendirildi. Tedaviye uyum, tolerans ve yan etkilerkaydedildi. Klinikteki düzelme (KD) değerlendirildi, farmakoekonomik inceleme yapıldı. Bulgular:Senna grubundaki KD anlamlı ölçüde yüksekti (p=0.036). Senna DK'da en fazlaiyileşme sağladı (p<0.001) ve fekal inkontinansı azalttı (p=0.039). Karındadistansiyon, karın ağrısı, bulantı/kusma ve anal fissür trimebutinle düzeldi(p<0.05). Senna ve trimebutin ağrılı defekasyonu ve dışkı tutmayı azalttı.Laktüloz iştahsızlık ve anal fissürü iyileştirdi. Senna en fazla maliyetetkinliği olan ilaçtı. Tartışma:Kabızlık için tedavi seçenekleri ağırlıklı görülen semptoma göre dizaynedilmelidir. Senna obesite ve/veya fekal inkontinans olan çocuklarda başlangıçtedavisi olarak önerilebileceği gibi, trimebutin karında distansiyon, karınağrısı, bulantı/kusma veya anal fissür olanlarda, laktüloz iştahsızlık veyaanal fissür olanlarda ayrı olarak seçilebilir.
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UR  - https://doi.org/10.12956/tchd.619141
L1  - https://dergipark.org.tr/tr/download/article-file/1154001
ER  -