Up-to-date approaches to treatment of the functional constipation at children
Abstract
The aim of review. To present diagnostic criteria of constipation of functional origin in children and to systematize approaches to medical programs development.
Original positions of the review. Functional constipation contributes 95% of all cases of constipation at children. According to ICD-10, in the respective section, irritable bowel syndrome (IBS) and functional constipation itself are traditionally distinguished. RomeIII criteria adjust diagnostic principles of these diseases. In pediatric practice it is important to distinguish hypertonic and hypotonic constipations. In medical programs significant place is given to laxatives, especially in cases of sub- or decompensated variants of constipation. Of them Forlax® preparation on the basis of macrogoal 4000 (polyethyleneglycol 4000) with potential of prescription of the latter from 6-month’s age deserves attention. In the literature there are data indicating safety and high performance of this pharmaceutical agent.
Conclusion. Rome criteria of IBS are applicable only in relation to children of middle and senior school age. At drawing up medical programs for children with functional constipation, it is advisable to take into account its type (spasmodic or hypotonic), degree of compensation, age of a child. At prescription of laxative agents it is necessary to choose drugs with osmotic mechanism of action.
References
1. Александрова В.А. Диагностика и лечение запоров у детей. – СПб: МАПО, 2004. – 24 с.
2. Бельмер С.В., Гасилина Т.В., Хавкин А.И., Эйберман А.С. Функциональные нарушения органов пищеварения у детей. – М., 2006. – 44 с.
3. Кущ Н.Л. Запоры у детей. – Киев, 1976. – 176 с.
4. Практическое руководство по детским болезням / Под ред. В.Ф. Коноплиной, А.Г.Румянцева. – Т. 2 (Гастроэнтерология детского возраста) / Под ред. С.В. Бельмера, А.И. Хавкина. – М.: Медпрактика-М, 2003. – С. 249–266.
5. Хавкин А.И. Микрофлора пищеварительного тракта. – М., 2006. – С. 171–374.
6. Хавкин А.И. Функциональные нарушения желудочно-кишечного тракта у детей раннего возраста. – М., 2000. – 72 с.
7. Хавкин А.И., Бабаян М.Л. Лечение хронических запоров (клиника, диагностика, лечение). – М.: Изд. НИИ педиатрии и детской хирургии, 2005. – 30 с.
8. Эрдес С.И. Запоры у детей // Фарматека. – 2007. – № 13. – С. 47–52.
9. Drossman D.A. The functional gastrointestinal disorders and the Rome III process // Gastroenterology. – 2006. – Vol. 130. – Р. 1377–1390.
10. Evaluation and treatment of constipation in infants and children. Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition // J. Pediatr. Gastroenterol. Nutr. – 2006. – Vol. 43. – N 3. – e1–e13.
11. Nelson textbook of pediatrics. – 17th ed. – Philadelphia, 2004. – Р. 1101–1187.
12. Pediatric gastrointestinal disease (pathophysiology, diagnosis, management) / Eds. R. Wyllie, J.S. Hyams. – Philadelphia, 1999. – Р. 271–550.
13. Pediatric gastrointestinal motility disorders / Eds. P.E. Hyman. – N.-Y., 1994. – Р. 129–145.
14. Pediatrics at a Glance / Eds. S.M. Altschuler, S. Ludwig. – Philadelphia, 1999. – P. 74–75.
15. Thompson W.G. The road to Rome // Gastroenterology. – 2006. – Vol. 130. – Р. 1552–1556.
Review
For citations:
Privorotsky V.F., Luppova N.Ye. Up-to-date approaches to treatment of the functional constipation at children. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2009;19(1):59-65. (In Russ.)
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