title: Comparison Between the Cassia Fistula`s Emulsion With Polyethylene Glycol (PEG4000) in the Pediatric Functional Constipation: A Randomized Clinical Trial.
abstract: BACKGROUND
  There are few effective drugs for pediatric functional constipation (FC).
  
  
  OBJECTIVE
  Comparing the effectiveness of Cassia fistula's emulsion (CFE) with Polyethylene glycol (PEG4000) in FC; and evaluation of safety of both drugs in the treatment of FC.
  
  
  METHODS
  A randomized open label, prospective, controlled, parallel-group clinical trial was carried on 109 children (M/F: 63/46; mean age ± SD: 59.7 ± 28.8 months) in Amirkola children's hospital, Babol, Iran. The inclusion criteria were based on diagnosis of FC according to the Rome III criteria and age range between 2 - 15 years. They received CFE or PEG randomly for 4 weeks. Frequencies of defecation, severity of pain, consistency of stool, fecal incontinence and retentive posturing were compared between the two groups and with baselines. Children were counted as improved when they exited from Rome III criteria of FC.
  
  
  RESULTS
  Fifty seven patients were assigned to receive PEG and 52 patients received CFE. After 4weeks of medication, 86.5% of children in CFE group and 77.1% in PEG group (RR = 1.121, CI95%:0.939 - 1.338) exited from the criteria of FC. All measurable criteria improved in both groups without any significant difference, except in the frequency of defecation that in CFE group (10.96 ± 5.7) was significantly more than PEG group (6.9 ± 3.5) (P < 0.0001). Compliances of PEG were significantly better in the 2 first weeks (P = 0.002, 0.008) but not in third and fourth week (P = 0.061, 0.062). None of these two drugs cause clinically significant side effects.
  
  
  CONCLUSIONS
  CFE can be as effective as PEG in the 4-weeks treatment of children with FC.
authors.affiliation: Department of Pediatrics, Non-Communicable Pediatric Disease Research Center, Babol University of Medical Sciences, Babol, IR Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Esmaeilidooki
authors.affiliation: Traditional Medicine and History of Medical Sciences Research Center, Babol University of Medical Sciences, Babol, IR Iran; Department of Traditional Iranian Medicine, Faculty of Traditional Iranian Medicine, Babol University of Medical Sciences, Babol, IR Iran.
authors.forename: Seyyed Ali
authors.initials: SA
authors.lastname: Mozaffarpur
authors.affiliation: Traditional Medicine and History of Medical Sciences Research Center, Babol University of Medical Sciences, Babol, IR Iran; Department of Traditional Iranian Medicine, Faculty of Traditional Iranian Medicine, Babol University of Medical Sciences, Babol, IR Iran.
authors.forename: Mohaddese
authors.initials: M
authors.lastname: Mirzapour
authors.affiliation: Department of Traditional Iranian Medicine, Faculty of Traditional Iranian Medicine, Babol University of Medical Sciences, Babol, IR Iran; Departments of Statistics and Biostatistics, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Hoda
authors.initials: H
authors.lastname: Shirafkan
authors.affiliation: School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Kamalinejad
authors.affiliation: Social Health Research Center, Babol University of Medical Sciences, Babol, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Bijani
keywords: Cassia fistula; Child; Clinical Trial; Constipation; Persian Medicine; Polyethylene Glycols