1Niloufar Ghanbari, 2Peymaneh Alizadeh Taheri,3Kambiz Eftekhari
1Department of Pediatrics, Tehran University of Medical Sciences, Bahrami Children Hospital, Tehran, Iran
2Department of Neonatology, Tehran University of Medical Sciences, Bahrami Children Hospital, Tehran, Iran
3Department of Gastroenterology, Tehran University of Medical Sciences, Bahrami Children Hospital, Tehran, Iran
DOI : https://doi.org/10.47191/ijmra/v6-i1-11Google Scholar Download Pdf
ABSTRACT:
Background: Recent evidence emphasizes the positive effect of probiotics and synbiotics in the treatment of functional constipation in childhood, but no study has surveyed the effectiveness of synbiotics in improving the clinical conditions in infants ≤6 months suffering from functional constipation, so we performed this study.
Aims: Comparing the efficacy and safety of two types of synbiotics including PediLact® (Zist-Takhmir Co., Tehran, Iran) drop containing Bifidobacterium infantis, Lactobacillus reuteri, Lactobacillus rhamnosus plus fructooligosaccharides with BBCare® (Zist-Takhmir Co., Tehran, Iran) drop containing Bifidobacterium lactis BB-12 plus fructooligosaccharides in the treatment of infantile functional constipation.
Study Design: This trial was performed on infants less than 6 months of age who met the ROME IV criteria for infantile functional constipation. The patients were randomly assigned to receive PediLact drop (n = 44) or BB-Care drop (n = 45) for one month and were evaluated on the seventh day and at the end of the first month.
Results: A significant downward trend was revealed in the responsive rate of every clinical symptom in both intervention groups but BB-Care was more effective than PediLact in improving the frequency of weekly defecation. Both synbiotics also improved significantly all symptoms of constipation in all types of feeding methods after one week and one month of intervention (primary outcomes). There was no side effect of synbiotics through intervention (secondary outcome).
Conclusions: This study shows that both synbiotics improved significantly all symptoms of functional constipation after one week and one month of intervention apart from type of feeding method in infants less than 6 months of age. Due to the greater effectiveness of BB-care in increasing stool frequency, B. lactis may play a more prominent role in this age group. This study has been registered at the Iranian Registry of Clinical Trails (IRCT20160827029535N7).
Infant, Functional constipation, Synbiotics, Treatment
REFERENCES
1) Walter AW, Hovenkamp A, Devanarayana NM, Solanga R, Rajindrajith S, Benninga MA. Functional constipation in infancy and early childhood: epidemiology, risk factors, and healthcare consultation. BMC Pediatr;2019;19(1):285. DOI: 10.1186/s12887-019-1652-y.
2) Ho JMD, How CH. Chronic constipation in infants and children. Singapore Med J. 2020;61(2):63-68. DOI: 10.11622/smedj.2020014.
3) Allen P, Setya A, Lawrence VN. Pediatric Functional Constipation. 2020;20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 30725722, Bookshelf ID: NBK537037.
4) Leung AKC, Hon KL. Pediatrics: how to manage functional constipation. Drugs Context. 2021; 10:2020-11-2. DOI: 10.7573/dic.2020-11-2. eCollection 2021.
5) van Mill MJ, Koppen IJN, Benninga MA. Controversies in the management of functional constipation in children. Curr Gastroenterol Rep. 2019; 21(6):23. DOI: 10.1007/s11894-019-0690-9.
6) Mugie SM, Benninga MA, Di Lorenzo C. Epidemiology of constipation in children and adults: a systematic review. Best Pract Res Clin Gastroenterol.2011; 25(1):3–18. DOI: 10.1016/j.bpg.2010.12.010.
7) Russo M, Strisciuglio C, Scarpato E, Bruzzese D, Casertano M, Staiano A. Functional chronic constipation: Rome III Criteria Versus Rome IV Criteria. J Neurogastroenterol Motil. 2019; 25(1):123-128. DOI: 10.5056/jnm18035.
8) Staiano A, Andreotti MR, Greco L, Basile P, Auricchio S. Long-term follow-up of children with chronic idiopathic constipation. Dig. Dis. Sci. 1994;39(3):561-4.9. DOI: 10.1007/bf02088343 PMID: 8131693.
9) Tabbers MM, Benninga MA. Constipation in children: fiber and probiotics. BMJ Clin Evid. 2015; 2015:0303. PMID: 25758093, PMCID: PMC4356179.
10) Pärtty A, Rautava S, Kalliomäki M. Probiotics on pediatric functional gastrointestinal disorders. Nutrients. 2018;10(12):1836. DOI: 10.3390/nu10121836.
11) Southwell BR. Treatment of childhood constipation: a synthesis of systematic reviews and meta-analyses. Expert Rev Gastroenterol Hepatol. 2020;14(3):163-174. DOI: 10.1080/17474124.2020.1733974.
12) Mugie SM, Di Lorenzo C, Benninga MA. Constipation in childhood. Nat Rev Gastroenterol Hepatol. 2011; 8(9):502-11. DOI: 10.1038/nrgastro.2011.130.
13) Santucci NR, Chogle A, Mascarenhas M, Leiby A, Borlack RE, Lee A, Perez M, Russell A, Yeh AM. Non-pharmacologic approach to pediatric constipation. Complement Ther Med. 2021; 59:102711. DOI: 10.1016/j.ctim.2021.102711.
14) Khodadad A, Sabbaghian M. Role of synbiotics in the treatment of childhood constipation: a double-blind randomized placebo-controlled trial. Iran J Pediatr. 2010;20(4):387-92. PMID: 23056736, PMCID: PMC3446081.
15) Ford AC, Quigley EM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, Soffer EE, Spiegel BM, Moayyedi P. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-61; quiz 1546, 1562. DOI: 10.1038/ajg.2014.202.
16) Ohkusa T, Koido S, Nishikawa Y, Sato N. Gut microbiota and chronic constipation: a review and update. Front Med (Lausanne). 2019; 6:19. DOI: 10.3389/fmed.2019.00019. eCollection 2019.
17) Huang L, Zhu Q, Qu X, Qin H. Microbial treatment in chronic constipation. Sci China Life Sci. 2018; 61(7):744-752. DOI: 10.1007/s11427-017-9220-7.
18) Baştürk A, Artan R, Atalay A, Yılmaz A. Investigation of the efficacy of synbiotics in the treatment of functional constipation in children: a randomized double-blind placebo-controlled study. Turk J Gastroenterol. 2017;28(5):388-93. DOI: 10.5152/tjg.2017.17097.
19) Rodriguez DA, Popov J, Elyanne M Radcliffe EM, Monjaraz EMT: Functional constipation and the gut microbiome in children: preclinical and clinical evidence. Front Pediatr.2021;20;8:595531. DOI: 10.3389/fped.2020.595531. eCollection 2020.
20) Hannah MJ, Soenarto SY. Effectiveness of synbiotics as laxative agent for constipation in children. Paediatr Indonediana. 2008; 48(3):136–41. DOI: 10.14238/pi48.3.2008.136-41.
21) Hashemi M, Javaheri J, Habibi M, Yousefichaijan P, Naziri M. Comparing the effect of probiotics and polyethylene glycol in treatment of children with functional constipation. Arak Med Univ J. 2015; 18(6):78–85.
22) Mahdavi M, Esmaeili Dooki MR, Mehrabani S, Hajiahmadi M, Moghadamnia AA, Moslemi L. The effect of adding synbiotics to polyethylene glycol in childhood functional constipation: a randomized clinical trial study. Int J Pediatr. 2017; 5(7):5357–67. DOI: 10.22038/IJP.2017.23141.1990.
23) Abediny M, Ataiee P, Afkhamzadeh A, Seifmanesh M, Sedaghat B. The effect of probiotics on the treatment of functional constipation in children of 4–12 years of age. J Isfahan Med Sch. 2016;33(368):2448–2454.
24) Russo M, Giugliano FP, Quitadamo P, Mancusi V, Miele E, Staiano A. Efficacy of a mixture of probiotic agents as a complementary therapy for chronic functional constipation in childhood. Ital J Pediatr; 2017;43(1):24. DOI: 10.1186/s13052-017-0334-3.
25) Jose S, K. MI. Effect of probiotics on constipation in children. Int J Contemp Pediatr.2017; 5:46. DOI: 10.18203/2349-3291.ijcp20175506.
26) Guerra PVP, Lima LN, Souza TC, Mazochi V, Penna FJ, Silva AM, et al. Pediatric functional constipation treatment with bifidobacterium-containing yogurt: a crossover, double-blind, controlled trial. World J Gastroenterol. 2011;17(34):3916–21. DOI: 10.3748/wjg. v17.i34.3916.
27) Sadeghzadeh M, Rabieefar A, Khoshnevisasl P, Mousavinasab N, Eftekhari K. The effect of probiotics on childhood constipation: a randomized controlled double-blind clinical trial. Int J Pediatr. 2014;2014: 937212. DOI: 10.1155/2014/937212.
28) Wegner A, Banaszkiewicz A, Kierkus J, Landowski P, Korlatowicz-Bilar A, Wiecek S, et al. The effectiveness of Lactobacillus reuteri DSM 17938 as an adjunct to macrogol in the treatment of functional constipation in children. A randomized, double-blind, placebo-controlled, multicentre trial. Clin Res Hepatol Gastroenterol. 2018; 42(5):494–500. DOI: 10.1016/j.clinre.2018.03.008.
29) Wojtyniak K, Horvath A, Dziechciarz P, Szajewska H. Lactobacillus casei rhamnosus Lcr35 in the management of functional constipation in children: a randomized trial. J Pediatr. 2017; 184:101-5. e1. DOI: 10.1016/j.jpeds.2017.01.068.
30) Banaszkiewicz A, Szajewska H. Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constipation in children: a double-blind, placebo-controlled randomized trial. J Pediatr. 2005; 146(3):364–9. DOI: 10.1016/j.jpeds.2004.10.022.
VOLUME 06 ISSUE 01 JANUARY 2023
There is an Open Access article, distributed under the term of the Creative Commons Attribution – Non Commercial 4.0 International (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/), which permits remixing, adapting and building upon the work for non-commercial use, provided the original work is properly cited.
Our Services and Policies
Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected.
The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.
International Journal of Multidisciplinary Research and Analysis will publish 12 monthly online issues per year,IJMRA publishes articles as soon as the final copy-edited version is approved. IJMRA publishes articles and review papers of all subjects area.
Open access is a mechanism by which research outputs are distributed online, Hybrid open access journals, contain a mixture of open access articles and closed access articles.
International Journal of Multidisciplinary Research and Analysis initiate a call for research paper for Volume 07 Issue 12 (December 2024).
PUBLICATION DATES:
1) Last Date of Submission : 26 December 2024 .
2) Article published within a week.
3) Submit Article : editor@ijmra.in or Online
Why with us
1 : IJMRA only accepts original and high quality research and technical papers.
2 : Paper will publish immediately in current issue after registration.
3 : Authors can download their full papers at any time with digital certificate.
The Editors reserve the right to reject papers without sending them out for review.
Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected. The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.