Oral versus rectal laxatives for functional constipation in child
Abstract: Functional
constipation is a common childhood condition. Benefits of oral and rectal
laxatives in terms of recovery and recurrence in children with functional constipation
are still controversial.
Objective To compare the effectiveness of oral and rectal laxatives in
terms of recovery and recurrence in children with functional constipation.
Methods Children aged 8 to 17 years who met the Rome III criteria for functional
constipation were enrolled in this open randomised trial. Data was collected
through questionnaires, interviews, and physical examinations. The participants
were randomly assigned to receive stimulant laxatives (5 mg bisacodyl) either
orally for three consecutive days or rectally in a single dose. Subjects kept
daily defecation records for 7 days, and were followed up on days 14, 21, 28,
35, and 42. Comparisons of defecation patterns and recurrence of constipation
between groups were assessed using Chi-square test.
Results Of 99 subjects, 46 children (5 boys, 41 girls) received oral
laxatives (group I) and 45 children (8 boys, 37 girls) received rectal
laxatives (group II). Four children in each group dropped out. Baseline
characteristics are comparable between the groups. Rate of recovery in the
first 7 days was higher in the oral compared to rectal groups [84.8% versus
73.3%, respectively, but this was not statistically sininficant (P=0.278)]. In
the second week, the recurrence of constipation was significantly higher in the
rectal (57.5%) than in the oral laxative group (42.5%) (P=0.026).
Conclusion Although recovery tends to occur more with oral compared to
rectal laxative agents, the difference was not statistically significant.
Higher recurrence in the second week after treatment occurred with rectal
laxative agent.
Author: Wiji Joko Pranoto, Supriatmo,
Melda Deliana, Atan Baas Sinuhaji
Journal Code: jpkedokterangg160058
