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Childhood constipation

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Defining constipation – what is it?

Constipation is defined as difficulty passing stools that may be infrequent (2 or less per week) and painful. In addition, stools can be hard and of a large diameter and the child may demonstrate withholding posture and behaviour.1a,2a,b

Functional constipation is a medical term for when otherwise healthy children experience constipation, with no medical conditions which may be the underlying cause.2c,3a

Constipation is unfortunately a common and distressing childhood problem.4a

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Facts on childhood constipation

  • No organic cause (underlying illness) is found in over 90 % of children with constipation.4a
  • Only 60 % of children with constipation have successful treatment with laxatives.4a
  • A sizable proportion of children need long-term therapy.4a
  • Childhood constipation tends to peak between 2 and 4 years of age and is often associated with toilet training.1b,4b
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Causes may include

  • Low consumption of dietary fibre
  • stress or anxiety
  • cow’s milk protein allergy
  • lack of exercise
  • the use of medications
  • Another important cause is now evident, and that there may be an imbalance in the gut flora of patients with constipation.4c
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Treating childhood constipation

General management

  • Increase fluid intake.1f-h
  • For children over 6 months of age, include more fibre in their diet.1g
  • Toilet training routines – allow children time to sit on the toilet for between 3 and 10 minutes.1i
  • Medications can help to soften the stool but are not always successful.1h,4a
  • Daily use of a clinically validated probiotic.4d,e

 

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How do probiotics work for childhood constipation?

Probiotics play an important role in restoring the balance of gut flora.5a,6a

In addition, probiotics might improve the time it takes for food to move through the colon. This is beneficial in constipation as hard bulky stools are difficult to pass.4d

Choosing a probiotic.

It is important to know that different types of probiotics have different health effects, the proven effect of one strain or species is not necessarily the same as another strain or species.7a,b

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The role of Reuterina® in childhood constipation

The bacteria used in Reuterina® is from the species Lactobacillus reuteri and, specifically, the strain DSM 17938.5b,6b

Clinical studies have shown that Reuterina® treats functional chronic (long-term) constipation in infants and children.3b,c,4h,9a

Clear evidence that Reuterina® works for constipation.4h,9a

Reuterina®

The Probiotic for Life.5c,6c

Always consult your healthcare professional to rule out any underlying causes for constipation in your baby or child, and for more information on your treatment choices.

Medical References

  1. Xinias I, et al. Constipation in Childhood. An update on evaluation and management. Hippokratia 2015;19(1):11-19.
  2. Hyams JS, et al. Childhood Functional Gastrointestinal Disorders: Child/Adolescent. Gastroenterology 2016;150:1456–1468.
  3. Olgac MAB, et al. Comparison of probiotic and lactulose treatments in children with functional constipation and determination of the effects of constipation treatment on quality of life. Turkish Pediatric Journal 2013;56:1-7.
  4. Coccorullo P, et al. Lactobacillus reuteri (DSM 17938) in infants with Functional Chronic Constipation: A Double-Blind, Randomised, Placebo-controlled study. The Journal of Paediatrics 2010;157(4):598-602.
  5. Reuterina® Drops Approved Package Insert, August 2009.
  6. Reuterina Junior® Approved Package Insert, July 2010.
  7. Indrio F, et al. Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation. A randomised clinical trial. JAMA Pediatr 2014;168:228-233.
  8. Weizman Z, et al. Lactobacillus reuteri DSM 17938 for the management of functional abdominal pain in childhood: a randomized, double-blind, placebo-controlled trial. J Pediatr 2016;174:160-164.
  9. Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria, 1-4 October 2001.

 

067 Reut ZA 11/2020

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