title: Free fatty acid suppositories are as effective as docusate sodium and sorbitol enemas in treating constipation in children.
abstract: OBJECTIVE
  A well-documented, clinically proven per rectum treatment for childhood constipation is needed. This phase two clinical trial evaluated the efficacy of suppositories containing free fatty acids (FFA) compared with Klyx docusate sodium and sorbitol enemas.
  
  
  METHODS
  A randomised, controlled, single-blind study was undertaken on 77 children aged between one and 17 who presented to an emergency department in Iceland and were diagnosed with constipation. In stage one, 23 patients were randomised to receive lower dose FFA suppositories or Klyx (n = 33). In stage two, 21 different patients were randomised to receive higher dose suppositories and compared with the same Klyx control subjects.
  
  
  RESULTS
  The suppositories were effective at bowel emptying in 39% of the group who received the lower FFA doses and 81% of the group receiving higher doses, compared with 88% in the Klyx control group. Symptom relief was obtained in 30% of the group receiving the lower doses and 71% of the group receiving the higher doses, compared with 73% in the control group.
  
  
  CONCLUSIONS
  The higher dose FFA suppositories were as effective as the Klyx enemas with regard to bowel emptying and symptom relief and might provide an important and less invasive alternative for childhood constipation.
authors.affiliation: Landspitali-University Hospital, Reykjavík, Iceland.
authors.forename: Orri Thor
authors.initials: OT
authors.lastname: Ormarsson
authors.affiliation: Lipid Pharmaceuticals, Reykjavík, Iceland.
authors.forename: Gudrun Marta
authors.initials: GM
authors.lastname: Asgrimsdottir
authors.affiliation: University of Iceland, Reykjavík, Iceland.
authors.forename: Thorsteinn
authors.initials: T
authors.lastname: Loftsson
authors.affiliation: Landspitali-University Hospital, Reykjavík, Iceland.
authors.forename: Einar
authors.initials: E
authors.lastname: Stefansson
authors.affiliation: University of Iceland, Reykjavík, Iceland.
authors.forename: Sigrun Helga
authors.initials: SH
authors.lastname: Lund
authors.affiliation: Landspitali-University Hospital, Reykjavík, Iceland.
authors.forename: Einar Stefan
authors.initials: ES
authors.lastname: Bjornsson
mesh_terms: D000285:Administration, Rectal; D002400:Cathartics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000188:drug therapy*; D003672:Defecation / Q000187:drug effects*; D004143:Dioctyl Sulfosuccinic Acid / Q000627:therapeutic use; D004733:Enema; D005230:Fatty Acids, Nonesterified / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013012:Sorbitol / Q000627:therapeutic use; D013488:Suppositories; D013501:Surface-Active Agents / Q000627:therapeutic use
chemical_list: D002400:Cathartics; D005230:Fatty Acids, Nonesterified; D013488:Suppositories; D013501:Surface-Active Agents; D004143:Dioctyl Sulfosuccinic Acid; D013012:Sorbitol
keywords: Clinical trial; Constipation; Free fatty acids; Laxative; Suppositories