Pädiatrie und Therapeutik
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Abstrakt

Consolidated Review of Evidence on Safety and Effectiveness of Osmotic Laxatives as Per Recommendations in Childhood Constipation

Karthick Annamalai, Ravishankar Ayathu Venkata, Arun Garg, Rajesh Khanna Palmamidi, Srichurnam Sreekar*, Krishna Chaitanya Veligandla, Amey Mane, Rahul Rathod

Childhood functional constipation is a common pediatric problem all over the world. The main goal of the treatment should be disimpaction of the stools, followed by maintenance therapy to prevent reimpaction. Significant number of children are evaluated by pediatric gastroenterologists because of frequent relapse of symptoms. There are wide variety of pharmacological options available in the treatment of functional constipation. Osmotic Laxatives are the most used intervention for treating functional constipation in children. But there is an uncertainty on the safety and efficacy of osmotic laxatives for the recommended duration of therapy. We conducted a review of evidence of osmotic laxatives usage for a minimum of 2 months and found that Polyethylene Glycol (PEG) was the most studied laxative for the recommended duration. Polyethylene glycol was associated with significant increase in bowel frequency and treatment success compared to placebo or other laxatives. Use of PEG was associated with significant less adverse effects like bloating, abdominal pain, pain in defecation, straining and need for rescue medication compared to lactulose. Conclusively PEG is the only laxative which is effective as well as safe for the recommended duration. PEG 3350 is the most widely studied form of Polyethylene glycol in children.