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Drugs for Treatment of Constipation-Predominant IBS01:21

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Constipation: Beyond the Old Paradigms.

Peter L Lu1, Hayat M Mousa2

  • 1Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.

Gastroenterology Clinics of North America
|October 20, 2018
PubMed
Summary
This summary is machine-generated.

Refractory constipation in children may stem from evacuation or motility disorders. Advanced diagnostics and treatments like novel medications, biofeedback, and surgery offer solutions for persistent pediatric constipation.

Keywords:
Antegrade continence enemaChildrenDefecation disorderEncopresisFecal incontinencePediatricsSacral nerve stimulationSacral neuromodulation

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Area of Science:

  • Pediatric Gastroenterology
  • Colorectal Surgery

Background:

  • Constipation is a prevalent issue in pediatric populations.
  • A subset of children experience persistent symptoms despite conventional therapies.

Purpose of the Study:

  • To outline diagnostic and management strategies for pediatric refractory constipation.
  • To highlight advanced interventions for complex cases.

Main Methods:

  • Anorectal and colonic manometry to diagnose rectal evacuation or colonic motility disorders.
  • Review of novel medications, biofeedback, botulinum toxin injections, antegrade continence enemas, sacral nerve stimulation, and colonic resection.

Main Results:

  • Manometry effectively identifies specific functional disorders.
  • Emerging pharmacologic and therapeutic options show promise in pediatric use.
  • Surgical interventions provide options for intractable cases.

Conclusions:

  • Accurate diagnosis via manometry is crucial for guiding treatment in refractory pediatric constipation.
  • A multimodal approach, including novel medications and interventions, is essential for managing complex cases.