title: Therapeutic Response for Functional Abdominal Pain in Children with Occult Constipation: Laxatives versus Prokinetic Drugs.
abstract: The relationship between functional abdominal pain (FAP) and occult constipation (OC) in children who did not meet the Rome III criteria for constipation has rarely been reported. This study aimed to estimate the prevalence of OC in patients with FAP and to compare the effectiveness of prokinetic drugs and laxatives for FAP and OC. Pediatric outpatients (n = 212; aged 4-15 years) who satisfied the Rome III criteria for childhood FAP were divided into 2 groups based on Leech scores: group 1 < 8; group 2 ≥ 8. Group 2 received either prokinetic drugs or laxatives and pain severity was assessed after 2 weeks, 1 month, and 3 months. A total 52.4% (111/212) of patients had OC in this study. More patients who received laxatives had reduced pain scores compared with those who received prokinetic drugs. Those treated with laxatives in group 2 had a better response than those treated with prokinetic drugs throughout the study period (P < 0.001, P < 0.001, and P = 0.002 after 2 weeks, 1 month, and 3 months, respectively). OC was frequently encountered in children with FAP. Laxatives can be more effective than prokinetic drugs for relieving symptoms of FAP in children with a Leech score ≥ 8 and suspected OC.
authors.affiliation: Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Eun Kyo
authors.identifier: http://orcid.org/0000-0001-8863-5729
authors.initials: EK
authors.lastname: Ha
authors.affiliation: Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Homin
authors.identifier: http://orcid.org/0000-0002-5105-4952
authors.initials: H
authors.lastname: Jang
authors.affiliation: Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea. jinped@cha.ac.kr.
authors.forename: Su Jin
authors.identifier: http://orcid.org/0000-0002-7388-8368
authors.initials: SJ
authors.lastname: Jeong
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007792:Lactulose / Q000627:therapeutic use; D054368:Laxatives / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000627:therapeutic use; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D005765:Gastrointestinal Agents; D054368:Laxatives; D011092:Polyethylene Glycols; D007792:Lactulose; C000595212:polyethylene glycol 3350
keywords: Functional Gastrointestinal Disorders; Laxatives; Occult Constipation; Pediatrics; Rome III Criteria