An Update of Pharmacological Management in Children with Functional Constipation.

IF 3.4 3区医学 Q1 PEDIATRICS

Pediatric Drugs Pub Date : 2023-05-01 DOI:10.1007/s40272-023-00563-0

Anna de Geus, Ilan J N Koppen, Robert B Flint, Marc A Benninga, Merit M Tabbers

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引用次数: 3

Abstract

Functional constipation is a common problem in childhood worldwide and has a great impact on social, physical, and emotional functioning of affected children and their caregivers. It is a clinical diagnosis based on the Rome IV criteria. Non-pharmacological treatment involves education, demystification, lifestyle advice, and toilet training. Pharmacological treatment consists of disimpaction, maintenance treatment, and eventually weaning if possible. Polyethylene glycol is considered as the first choice of laxative for both disimpaction and maintenance treatment. Different osmotic laxatives, stimulant laxatives, lubricants, and enemas are available as alternative pharmacological treatment options. Novel drugs are emerging but evidence to support the widespread application of these drugs in the pediatric population is often lacking and more high-quality research is needed in this field. If children remain symptomatic despite optimal pharmacological treatment, botulinum toxin injections in the anal sphincter can be considered as an alternative, more invasive treatment option. This review provides an update on currently available literature concerning the pharmacologic treatment of functional constipation in children.

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儿童功能性便秘的药理治疗进展。

功能性便秘是世界范围内儿童的常见问题，对受影响儿童及其照顾者的社会、身体和情感功能有很大影响。这是一种基于罗马IV标准的临床诊断。非药物治疗包括教育、去神秘化、生活方式建议和如厕训练。药物治疗包括去除嵌塞，维持治疗，如果可能的话，最终断奶。聚乙二醇被认为是消除嵌塞和维持治疗的首选泻药。不同的渗透性泻药，刺激性泻药，润滑剂和灌肠剂可作为替代药物治疗方案。新药物不断涌现，但支持这些药物在儿科人群中广泛应用的证据往往缺乏，这一领域需要更多高质量的研究。如果患儿在最佳药物治疗后仍有症状，可以考虑在肛门括约肌注射肉毒杆菌毒素作为另一种更具侵入性的治疗选择。这篇综述提供了最新的现有文献关于功能性便秘在儿童的药物治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Drugs PEDIATRICS-PHARMACOLOGY & PHARMACY

CiteScore

7.20

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Pediatric Drugs promotes the optimization and advancement of all aspects of pharmacotherapy for healthcare professionals interested in pediatric drug therapy (including vaccines). The program of review and original research articles provides healthcare decision makers with clinically applicable knowledge on issues relevant to drug therapy in all areas of neonatology and the care of children and adolescents. The Journal includes: -overviews of contentious or emerging issues. -comprehensive narrative reviews of topics relating to the effective and safe management of drug therapy through all stages of pediatric development. -practical reviews covering optimum drug management of specific clinical situations. -systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. -Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in the pediatric population. -original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Pediatric Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.