Selenium and functional constipation in children
Abstract: Constipation is a
common problem in children, with approximately 90 to 95% of constipation cases
having functional constipation. Oxidative stress may be a causative factor in
gastrointestinal diseases, alleved by intervention with antioxidants. Selenium
is an essential trace element and acts as a cofactor of gluthathione
peroxidase, which protects membranes from oxidative damage.
Objective To determine the effect of selenium on functional constipation
in children.
Methods We conducted a single-blind, randomized clinical trial from
November to December 2012 at the Al-Kautsar Al-Akbar Islamic Boarding School in
Medan, North Sumatra. Subjects were children aged 12 to 17 years with
functional constipation, diagnosed according to the ROME III criteria. Patients
were randomly allocated into either the selenium group (n=57) or the placebo
group (n=57). Subjects were clinically evaluated for frequency of defecation,
stool consistency, severity of abdominal pain, and side effects during the 2
weeks of treatment (days 7 and 14) and 1 week after treatment had stopped (day
21).
Results A total of 114 subjects were eligible to participate. The average
frequency of defecation observed on day 14 was 1.5 (SD 0.75) days per
defecation (P=0.0001) in the selenium group and 2.4 (0.84) days per defecation
in the placebo group, a statistically significant difference (P=0.0001). There
was no significant difference in frequency of defecation on the 7th day of
treatment. But after day 7, there were significant differences between the
groups at days 14 and 21. Normal stool consistency was found in 45 subjects
(78.9%) on day 7 and in 57 subjects (100%) on day 14 of treatment in the
selenium group, significantly more than those in the placebo group (P<0.05).
In placebo group, normal stool consistency was found in 27 subject (47.4%) with
(P=0.001) on day 7 and in 38 subject (66.7%) on day 14 of treatment (P=0.0001).
On day 14, the selenium group had significantly more subjects without pain than
the placebo group [47 subjects (82.5%) vs. 10 subjects (17.5%), respectively
(P=0.0001)]. Severity of abdominal pain after 14th day of treatment is without
pain 47 subject (82.5%) and mild pain 10 subject (17.5%) (P=0.0001). We found
no side effects of selenium treatment in our subjects.
Conclusion Selenium is effective in improving clinically functional
constipation, in terms of increased frequency of defecation, normalization of
stool consistency, and less severe abdominal pain.
Author: Marlina Tanjung,
Supriatmo Supriatmo, Melda Deliana, Ade Rachmat Yudiyanto, Atan Baas Sinuhaji
Journal Code: jpkedokterangg160037
