work best for constipation

CLINICAL INQUIRIES Evidence Based Answersfrom the Family PhysiciansInquiries Network

What treatments work bestfor constipation in children?Evidence-based answerOsmotic laxatives produce the bestresults. Fiber and behavior modificationmay have a role. Increased fiber andbehavior modification are the most oftenrecommended first steps in managingchronic functional constipation (CFC) inchildren, but only limited evidence supports

I Evidence summaryCFC with or without encopresis is a com-mon pdiatrie problem that's distressingto both the child and family. High-qualityRCTs on managing CFC are lacking. Oursearch located 7 relevant RCTs'^ and 2relevant systematic reviews.^ '^ The TABLEsummarizes the RCTs.

Fiber may helpand doesn't hurtA fair-quality crossover RCT (31 chil-dren, mean age 7 years, with CFC) com-pared fiber (glucomannan) with placebofor 4 weeks.' More children were suc-cessfully treated with fiber than placebo(45% vs 13%; number needed to treat[NNT]=3.125; ?

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