Differential approach in the treatment of chronic constipation in children with congenital bowel malformations

Authors: V.V. Berezhny, V.G. Kozachuk, V.F. Ribalchenko

National Medical Academy of Postgraduate Education named after P.L. Shupyk, Kyiv, Ukraine


Objective — to study the clinical efficacy of the drug «Medulak» in the complex therapy of chronic constipation in children that arose against the background of congenital malformation of the large intestine.

Patients and methods

A clinical study of 30 children with chronic constipation, which arose against the background of a congenital malformation of the large intestine, was carried out. The mean age of the patients was 7.5±2.1 years. The diagnosis was verified on the basis of anamnesis data, patient complaints, clinical examination, digital examination of the rectum, laboratory methods, ultrasound scanning of the abdominal organs, and irrigography. Patients in the complex of therapy received the drug “Medulac”. The effectiveness of therapy was monitored on the 15th and 30th day of treatment.

Results

According to the results of irrigography, signs of doliocolon were detected in 10 (33.3%) patients, megadolichocolon – in 6 (20%), megacolon – in 3 (10%), dolichocolon + Payr’s syndrome – in 3 (10%), megacolon + Payr’s syndrome — in 2 (6.6%), dolichocolon + megarectum — in 2 (6.6%), megadolichosigma — in one child. Before treatment, along with gastrointestinal disorders, dermatointerstitial and vegetative manifestations were observed in children. During the observation, the majority of children showed a violation of the intestinal microbiota. According to the results of a coprological study, 26 (86.7%) children had insufficient digestion of proteins, fats and carbohydrates. During treatment with Medulak, positive clinical dynamics were observed in all patients. On the 15th day of therapy, half of the patients did not have any clinical symptoms of constipation. A positive clinical effect was observed in the majority of children (93.3%).

Conclusions

The inclusion of the drug «Medulak»in the complex therapy of chronic constipation in children with congenital malformations of the large intestine has good therapeutic efficacy, improves the nature of the stool, stimulates intestinal motility, normalizes its microbiocenosis and prevents complications, which allows us to recommend its use in the practice of pediatricians, general practitioners practices – family doctors and pediatric surgeons.

Key words: children, constipation, congenital malformation of the large intestine, Medulak.

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