Red Sugar versus Polyethylene Glycol 3350 in Pediatric Functional Constipation: A randomized and Active-Controlled Trial

Document Type : Original Article

Authors

1 Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran

2 Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Erfan Niayesh Hospital, Tehran, Iran

4 Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran

5 Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran

10.22034/jchr.2020.1895413.1112

Abstract

Functional constipation is a prevalent problem in children. This study was designed to compare the efficacy and safety of molasses with polyethylene glycol (PEG) in childhood constipation. This randomized single-center trial was conducted in Amir Al-Momenin Hospital, Semnan, Iran. 110 constipated children aged from 2 to 8 years were randomly assigned to 2 g/kg PEG or 2 ccs/kg molasses. Children were treated for 1 month, and frequency of defecation, frequency of encopresis, abdominal pain, appetite, fecaloma, and pain at defecation were compared. The safety of both treatments was also studied. After 1 month of treatment, both drugs had an equal effect on the frequency of defecation and the frequency of encopresis per week (P <0.05). Both drugs were effective in relieving defecation pain to some extent. Molasses had a better effect on appetite status (P <0.05). Molasses caused a lower rate of side effects; diarrhea (P <0.01), nausea (P <0.05), and vomit. Our study showed that red sugar was as effective as PEG 3350 for treating childhood functional constipation.

Keywords


1. Loening-Baucke V., 2005. Prevalence, symptoms and outcome of constipation in infants and toddlers. The Journal of Pediatrics. 146(3), 359-363.
2. Vandenplas Y., Abkari A., Bellaiche M., Benninga M., Chouraqui J. P., ÇokuÐraþ F., Harb T., Hegar B., Lifschitz C., Ludwig T., 2015. Prevalence and health outcomes of functional gastrointestinal symptoms in infants from birth to 12 months of age. Journal of Pediatric Gastroenterology and Nutrition. 61(5), 531.
3. Leung A.C.P., Cho H., 1996. Constipation in children. American Family Physician. 54(2), 611-618.
4. Biggs W.S., Dery W.H., 2006. Evaluation and treatment of constipation in infants and children. American Family Physician. 73(3), 469-477.
5. Marvdashti L.M., Abdolshahi A., Hedayati S., Sharifi-Rad M., Iriti M., Salehi B., Sharifi-Rad J., 2018. Pullulan gum production from low-quality fig syrup using Aureobasidium pullulans. Cellular and Molecular Biology. 64(8), 22-26.
6. Arabameri M., Nazari R.R., Abdolshahi A., Abdollahzadeh M., Mirzamohammadi S., Shariatifar N., Barba F.J., Mousavi Khaneghah A., 2019. Oxidative stability of virgin olive oil: evaluation and prediction with an adaptive neuro‐fuzzy inference system (ANFIS). Journal of the Science of Food and Agriculture. 99(12), 5358-5367.
7. Pashankar D.S., 2005. Childhood constipation: evaluation and management. Clinics in Colon and Rectal Surgery. 18(02), 120-127.
8. Rowan-Legg A., Society C.P., Committee C.P., 2011. Managing functional constipation in children. Paediatrics & Child Health. 16(10), 661-665.
9. Noripour S., Molaei A., Bandari R., Emadi A., Far S.M.F., Forozeshfard M., 2017. Comparison of the results of simultaneous surfactant administration and nasal continuous positive airway pressure (INSURE) and Non-administration of surfactant for the treatment of infants with respiratory distress syndrome. Journal of Comprehensive Pediatrics. 8(1), e37462.
10. Dupont C., Leluyer B., Maamri N., Morali A., Joye J.P., Fiorini J.M., Abdelatif A., Baranes C., Benoit S., Benssoussan A., 2005. Double-blind randomized evaluation of clinical and biological tolerance of polyethylene glycol 4000 versus lactulose in constipated children. Journal of Pediatric Gastroenterology and Nutrition. 41(5), 625-633.
11. Voskuijl W., de Lorijn F., Verwijs W., Hogeman P., Heijmans J., Mäkel W., Taminiau J., Benninga M., 2004. PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial. Gut. 53(11), 1590-1594.
12. DiPalma J.A., DeRidder P.H., Orlando R.C., Kolts B.E., vB Cleveland M., 2000. A randomized, placebo-controlled, multicenter study of the safety and efficacy of a new polyethylene glycol laxative. The American Journal of Gastroenterology. 95(2), 446-450.
13. Sharafkandi A., Avicenna H., 1978. Ghanoon Dar Teb [The Canon of Medicine], Bulaq Edition. Trans Tehran: Univ of Tehran Pr.5-37.
14. Tajik P., Goudarzian A.H., Shadnoush M., Bagheri B., 2018. Effect of red sugar on functional constipation in children compared to figs syrup; a randomized controlled trial study. Gastroenterology and Hepatology from Bed to Bench. 11(4), 313-318.
15. Parsaei P., Bahmani M., Naghdi N., Asadi-Samani M., Rafieian-Kopaei M., 2016. The most important medicinal plants effective on constipation by the ethnobotanical documents in Iran: A review. Der Pharmacia Lettre. 8(2), 188-194.
16. Nimrouzi M., Sadeghpour O., Imanieh M.H., Shams-Ardekani M., Zarshenas M.M., Salehi A., Minaei M.B., 2014. Remedies for children constipation in medieval Persia. Journal of Evidence-Based Complementary & Alternative Medicine. 19(2), 137-143.
17. Van der Plas R., Benninga M., Büller H., Bossuyt P., Akkermans L., Redekop W., Taminiau J., 1996. Biofeedback training in treatment of childhood constipation: a randomised controlled study. The Lancet. 348(9030), 776-780.
18. Loening-Baucke V., Pashankar D.S., 2006. A randomized, prospective, comparison study of polyethylene glycol 3350 without electrolytes and milk of magnesia for children with constipation and fecal incontinence. Pediatrics. 118(2), 528-535.
19. Hansen S.E., Whitehill J.L., Goto C.S., Quintero C.A., Darling B.E., Davis J., 2011. Safety and efficacy of milk and molasses enemas compared with sodium phosphate enemas for the treatment of constipation in a pediatric emergency department. Pediatric Emergency Care. 27(12), 1118-1120.
20. Vilke G.M., DeMers G., Patel N., Castillo E.M., 2015. Safety and efficacy of milk and molasses enemas in the emergency department. The Journal of Emergency Medicine. 48(6), 667-670.
21. Rafati M., Karami H., Salehifar E., Karimzadeh A., 2011. Clinical efficacy and safety of polyethylene glycol 3350 versus liquid paraffin in the treatment of pediatric functional constipation. DARU: Journal of Faculty of Pharmacy. Tehran University of Medical Sciences. 19(2), 154-158.