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The effectiveness of Lactobacillus reuteri DSM 17938 as an adjunct to macrogol in the treatment of functional constipation in children. A randomized, double-blind, placebo-controlled, multicentre trial - 18/10/18

Doi : 10.1016/j.clinre.2018.03.008 
Agnieszka Wegner a, b, , Aleksandra Banaszkiewicz c, Jaroslaw Kierkus b, Piotr Landowski d, Anna Korlatowicz-Bilar e, Sabina Wiecek f, Jaroslaw Kwiecien g, Agnieszka Gawronska c, Lukasz Dembinski c, Grazyna Czaja-Bulsa e, h, Piotr Socha b
a Department of Child Neurology, Medical University of Warsaw, Warsaw, Poland 
b Department of Gastroenterology, Hepatology, Nutritional Disorders and Paediatrics, Children's Memorial Health Institute, Warsaw, Poland 
c Department of Paediatrics, Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland 
d Department of Paediatrics, Gastroenterology and Eating Disorders, Medical University of Gdansk, Gdansk, Poland 
e Department of Paediatrics, Gastroenterology and Rheumatology, Children's Hospital, Szczecin, Poland 
f Department of Paediatrics, Gastroenterology Unit, Medical University of Silesia, Katowice, Poland 
g Department of Gastroenterology, Hepatology of Children, Medical University of Silesia, Zabrze, Poland 
h Paediatrics and Paediatric Nursery Unit, Pomeranian Medical University, Szczecin, Poland 

Corresponding author at: Department of Child Neurology, Medical University of Warsaw, Warsaw, Poland.Department of Child Neurology, Medical University of Warsaw, Warsaw, Poland.

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Highlights

What is already known on this subject?
Lactobacillus reuteri DSM 17938 is effective in constipation therapy in children.
What are the new findings?
The use of L. reuteri with macrogol had no positive effect on constipation treatment.
How might it impact on clinical practice in the foreseeable future?
This probiotic plays a valuable role in functional gastrointestinal disorder therapies.
However the drugs interactions can greatly reduce the L. reuteri beneficial effect.

Il testo completo di questo articolo è disponibile in PDF.

Summary

Objective

Constipation is one of the most common problems among children, with a prevalence ranging from 7 to 30%. It is treated with defecation training and laxative medications. However, many patients do not respond to the standard therapy. There is, therefore, an increasing interest in probiotics for the treatment of functional constipation.

Study design

The aim of this study was to assess the effectiveness of Lactobacillus reuteri DSM 17938 as an adjunct to macrogol in the treatment of functional, intractable constipation in children. A double-blind, placebo-controlled, randomized, multicentre trial involved a group of 129 children with functional constipation who were treated with a poor effect for at least two months prior to the study. Patients were randomly assigned to one of the two groups: 1. L. reuteri DSM 17938 and macrogol or 2. macrogol and matching placebo for 8 weeks.

Results

121 patients completed the study. Almost all patients (119/129) increased their bowel movements in both groups (59 vs 60, ns.) and there was no statistically significant difference in the number of bowel movements per week in week 8 between the study and the placebo group (7.5±3.3 vs 6.9±2.5, respectively). Additionally, there were no significant differences between groups in the numbers of patients complaining of pain during defecation (13/47 vs 8/53), abdominal pain (19/41 vs 25/36), withholding stools (15/45 vs 13/48), passing hard stools (7/53 vs 3/58) or large stools (14/46 vs 12/49), and faecal incontinence (17/43 vs 11/50).

Conclusion

L. reuteri DSM 17938 supplementation as an additional therapy to macrogol did not have any beneficial effect on the treatment of functional constipation in children aged 3–7 years.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Lactobacillus reuteri DSM 17938, Children, Constipation


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Vol 42 - N° 5

P. 494-500 - Ottobre 2018 Ritorno al numero
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