Constipation Clinical Trial
Official title:
Effect of the Prebiotic 4'Galactooligosaccharides in Children and Adolescents With Functional Constipation
Some prebiotics are useful for improving symptoms related to constipation, but clinical trials including infants and older children are scarce. A double-blind, placebo-controlled, crossover clinical trial was conducted to evaluate the effect of galactooligosaccharides (GOS) on functional constipation in children and adolescents. Twenty children aged 4 to 16 years of age, who spontaneously sought medical care at a primary healthcare unit, received 1.7g GOS or placebo (Maltodextrin) treatment for 30 days, followed by a 15-day washout period and a 30-day use of an alternative product. A clinical score was calculated at baseline, at the 15th (D15) and 30th (D30) day of each period, to assess bowel movement frequency, straining/ pain during defecation and stool consistency. Oral anal transit time with activated charcoal was determined at baseline and D30 of each period.
Constipation is a common symptom in the pediatric clinics. It is usually defined in terms of
difficulty of passage of faeces, faecal consistency and frequency of evacuation. A diet
containing high amounts in fiber can promote beneficial effects constipation therapy. Beside
the fiber, functional foods, such as prebiotics, have been considered useful to regulate
bowel movements. Prebiotic is defined as nondigestible food components that affect the host
for stimulating selectively growth of potentially beneficial bacteria in the intestines,
specially the colon. Nowadays, there are few clinical trials evaluating prebiotic use for
relieving constipation symptoms in children. This clinical trial aimed to evaluate the
effect of Galactooligossacharides (GOS) on constipated children. The trial consisted of a
75-day period double blind intervention, controlled with placebo and cross over
delimitation, with two sequences of evaluation and two treatments, placebo and
galactooligossacharides. It included 20 children (4-16 years) with functional constipation
defined by the ROMA III criteria. Children have received 6g of GOS or 6g Maltodextrin
(placebo), the solution was ingested for 30 days, followed by a washout period of 15 days,
and afterwards, 30 more days of GOS or Maltodextrin, alternately with the product ingested
in the first 30 days. The study was designed according to crossover delimitation (GOS and
Placebo). Eleven patients were evaluated according to the sequence GOS/placebo and nine
patients with the sequence Placebo/GOS. A severity score was measured at the beginning, 2nd
and 4th week in each experiment. Clinical scores, elaborated for this Trial, were used to
evaluate the effect of the products considering: stool frequency, presence of
pain/discomfort/effort during evacuation, consistency of stool and loss of appetite or early
satiety. Scores were calculated at day zero (D0), 15th day (D15) and 30th day (D30) of the
study, in each phase of the "crossover". Oroanal transit evaluation was performed on D0 and
D30 of each sequence, by activated charcoal ingestion.
Descriptive analysis trough measures of position and dispersion were realized for numerical
variables. ANOVA was used for the analysis of GOS effect. The significance level assumed for
the statistical tests was 5%. The GOS presented significant effect compared to placebo,
reducing the stool consistency p< 0,0001 and rising the stool frequency, p=0,0014. The value
of the oroanal transit time were significant lower in GOS period, p<0,0001. GOS was
effective at the improvement of mild constipation symptoms and may represent an alternative
option for the therapy of this condition.
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Allocation: Non-Randomized, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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