Role of laxative in chronic abdominal pain in paediatric age group
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 3
Abstract
The aims of the study were to identify the frequency and causes of chronic abdominal pain in paediatric age group (age 4 to 12 years) and to study use of laxative in chronic abdominal pain presented from June 2014 till June 2016 at RCSMGMC and CPR hospital Kolhapur. We evaluated prospectively the complete charts of children >4 years old, for complaints and causes of chronic abdominal pain. Of 200 patients evaluated 90 were boys and 110 girls with a mean age of 9.1 years. All patients were evaluated for chronic abdominal pain and put on intensive laxative therapy followed by maintenance dose. Although many laxative agents are used, we used an agent polyethylene glycol (PEG) to prevent comparative bias. At the time of evaluation, the mean duration of PEG therapy was 5.7 months, and the mean PEG dose was 0.75 g/kg daily. There were no major clinical adverse effects. All children preferred PEG to previously used laxatives, and daily compliance was measured as good in 90% of children. Constipation as cause of abdominal pain occurred in 87% (174 out of 200) of patient and relieved by laxatives, childhood functional abdominal pain in 5%(10 out of 200), colic in 3% (6 out of 200), gastro esophageal reflux in 3.5% (7 out of 200) and infection in 1.5% (3 out of 200). Functional constipation was the most frequent cause of chronic abdominal pain in a large primary care paediatric population. A careful history and thorough physical examination is all that is required to diagnose functional constipation. Management includes disimpaction followed by maintenance therapy with oral laxative, dietary modification and toilet training. In most of the cases laxative needs to be continued for several months and sometimes years. Early withdrawal of laxative is the commonest cause of recurrence.
Authors and Affiliations
Shivprasad Hirugade, Harish N Patil, Shilpa S Hirugade
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