Functional Constipation Clinical Trial
Official title:
The Use of Lactobacillus Reuteri in Functional Constipation in Children: A Double Blind Randomized Control Trial
Functional constipation (FC) is a common condition in childhood, with an estimated prevalence of 0.7% to 29%.The diagnosis and treatment of FC can be difficult tasks, and children are often referred to specialist services causing treatment to become expensive and time-consuming.The standard treatment based on osmotic laxatives (mainly PEG). The recovery rate is 50% to 60% after 1 year of treatment, with 50% of the children having relapse within 5 years. Studies in adults have established the effectiveness of some lactic acid bacteria in the treatment of chronic constipation.
Functional constipation (FC) is a common condition in childhood, with an estimated prevalence
of 0.7% to 29%.The diagnosis and treatment of FC can be difficult tasks, and children are
often referred to specialist services causing treatment to become expensive and
time-consuming.The standard treatment based on osmotic laxatives (mainly PEG). The recovery
rate is 50% to 60% after 1 year of treatment, with 50% of the children having relapse within
5 years. Studies in adults have established the effectiveness of some lactic acid bacteria in
the treatment of chronic constipation.However, it is unclear whether similar effects occur in
children. Lactobacilli and Bifidobacteria are the most studied species showing a high safety
profile. Both are able to promote colonic peristalsis which could be beneficial for the
treatment of constipation .Even though traditional treatment is well established and safe,
high proportion of children need prolonged treatment for several months or even years. For
many parents there is a concern regarding prolonged treatment with PEG .Lactobacilli,
bifidobacteria and FOS (fructooligosaccharide) increase stool frequency and decrease
consistency in healthy adults and therefore could prevent recurrence of constipation after
PEG withdrawal .The principle investigator hypothesize that treatment with probiotics adjunct
to PEG and several months thereafter could decrease the proportion of children needed
permanent or prolonged treatment (>12 months) with PEG.
The importance of the study and its practical benefits:
Treatment with PEG for FC is well established and is considered safe. Despite that, a high
proportion of children need prolonged treatment for several months or even years. For many
parents there is a concern regarding prolonged treatment with PEG. Previous studies did not
demonstrate efficacy of treatment with probiotics or prebiotics in FC. Neither of these
studies assessed effectiveness probiotics/prebiotic products as adjunct to the traditional
treatment (PEG) of FC in shortening its period.
A recently published studies including from Israel, demonstrated efficacy of Lactobacillus
reuteri in irritable bowel syndrome, infantile colic and functional abdominal pain
.Therefore, demonstration of positive effect of treatment with probiotic product in FC, could
imply for potential use of this product in other functional gastrointestinal disorders among
children.
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