Emma Children's Hospital, Academic Medical Centre, Department of Pediatric Gastroenterology and Nutrition, C2-312, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Expert Opin Pharmacother. 2013 Jan;14(1):41-51. doi: 10.1517/14656566.2013.752816. Epub 2012 Dec 10.
Childhood constipation is a common problem, varying from mild and short-lived to severe and chronic. In the majority of children, no organic cause can be identified and complaints are, thus, referred to as functional constipation. Infrequent painful defecation in combination with fecal incontinence has a significant impact on a child's quality of life. Pharmacological treatment often consists of fecal disimpaction and maintenance therapy. With current treatment options, results are often disappointing.
The aim of this review is to provide an overview of current and future pharmacological therapies for functional constipation in childhood.
Despite the widespread use of laxatives, there is a paucity of evidence to support this practice. No strong conclusions can be drawn on which laxative to prefer over the other. However, polyethylene glycol appears to be a reasonable first choice for maintenance therapy. Due to advances in our understanding of intestinal (patho)physiology, new classes of drugs have been developed. Data from adult studies are promising; however, pediatric data are lacking. Ongoing and future studies have to determine the efficacy and safety of these new drugs in the treatment of functional constipation in children.
儿童便秘是一种常见问题，其严重程度和持续时间各不相同，从轻度和短暂到严重和慢性。在大多数儿童中，无法确定器质性原因，因此将其称为功能性便秘。排便频率低伴粪便失禁会对儿童的生活质量产生重大影响。药物治疗通常包括粪便排出和维持治疗。目前的治疗选择往往效果不佳。
本文旨在综述儿童功能性便秘的当前和未来药物治疗方法。
尽管泻药的应用广泛，但支持这种治疗方法的证据很少。对于哪种泻药更优，无法得出明确结论。然而，聚乙二醇似乎是维持治疗的合理首选。由于我们对肠道（病理）生理学的理解不断进步，已经开发出了新类别的药物。来自成人研究的数据很有前景；然而，儿科数据却缺乏。正在进行和未来的研究必须确定这些新药在治疗儿童功能性便秘中的疗效和安全性。
