Sayre Casey L, Yellepeddi Venkata Kashyap, Job Kathleen M, Krepkova Lubov V, Sherwin Catherine M T, Enioutina Elena Y
Division of Clinical Pharmacology, Pediatrics, School of Medicine, Salt Lake City, UT, United States.
College of Pharmacy, Roseman University of Health Sciences, South Jordan, UT, United States.
Front Pharmacol. 2023 Jan 27;14:1051442. doi: 10.3389/fphar.2023.1051442. eCollection 2023.
Infants, children, and adolescents are at risk of experiencing a multitude of gastrointestinal disorders (GID). These disorders can adversely affect the quality of life or be life-threatening. Various interventions that span the conventional and complementary therapeutic categories have been developed. Nowadays, parents increasingly seek complementary options for their children to use concurrently with conventional therapies. Due to the high prevalence and morbidity of diarrhea, constipation, and irritable bowel syndrome (IBS) in children, in this review, we decided to focus on the current state of the evidence for conventional and complementary therapies used for the treatment of these diseases in children. Diarrhea treatment focuses on the identification of the cause and fluid management. Oral rehydration with supplementation of deficient micronutrients, especially zinc, is well established and recommended. Some probiotic strains have shown promise in reducing the duration of diarrhea. For the management of constipation, available clinical trials are insufficient for conclusive recommendations of dietary modifications, including increased use of fruit juice, fiber, and fluid. However, the role of laxatives as conventional treatment is becoming more established. Polyethylene glycol is the most studied, with lactulose, milk of magnesia, mineral oil, bisacodyl, and senna presenting as viable alternatives. Conventional treatments of the abdominal pain associated with IBS are poorly studied in children. Available studies investigating the effectiveness of antidepressants on abdominal pain in children with IBS were inconclusive. At the same time, probiotics and peppermint oil have a fair record of benefits and safety. The overall body of evidence indicates that a careful balance of conventional and complementary treatment strategies may be required to manage gastrointestinal conditions in children.
婴儿、儿童和青少年有患多种胃肠道疾病(GID)的风险。这些疾病会对生活质量产生不利影响,甚至危及生命。人们已经开发出了涵盖传统和补充治疗类别的各种干预措施。如今,家长们越来越多地为孩子寻求补充治疗方案,以便与传统疗法同时使用。由于腹泻、便秘和肠易激综合征(IBS)在儿童中发病率高,在本综述中,我们决定重点关注用于治疗儿童这些疾病的传统和补充疗法的现有证据状况。腹泻治疗的重点是查明病因和液体管理。口服补液并补充缺乏的微量营养素,尤其是锌,是成熟且被推荐的方法。一些益生菌菌株在缩短腹泻持续时间方面已显示出前景。对于便秘的管理,现有的临床试验不足以对饮食调整(包括增加果汁、纤维和液体的摄入)给出确凿的建议。然而,泻药作为传统治疗方法的作用正变得越来越明确。聚乙二醇是研究最多的,乳果糖、氧化镁乳剂、矿物油、比沙可啶和番泻叶也是可行的替代药物。儿童中关于IBS相关腹痛的传统治疗研究较少。现有调查抗抑郁药对IBS患儿腹痛有效性的研究尚无定论。与此同时,益生菌和薄荷油在益处和安全性方面记录良好。总体证据表明,可能需要谨慎平衡传统和补充治疗策略来管理儿童的胃肠道疾病。