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Comparison of three therapeutic interventions for chronic constipation in paediatric patients with cerebral palsy: a
Mohammad Hadi Imanieh1, Mohammad Reza Golpayegan2, Mostafa Sedighi3
1Department of Paediatric Gastroenterology, Gastroenterohepatology Research Centre of Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
The combination of polyethylene glycol (PEG) and Motilium is the most effective treatment for chronic constipation in children with cerebral palsy (CP). Motilium alone showed minimal benefit, while PEG offered moderate improvement.
Area of Science:
- Pediatrics
- Gastroenterology
- Neurology
Background:
- Cerebral palsy (CP) is a non-progressive movement disorder resulting from developmental brain injuries.
- Chronic constipation is a common and impactful condition in children with CP, affecting their well-being.
- Effective management of constipation is crucial for improving the overall health of CP patients.
Purpose of the Study:
- To compare the efficacy of three distinct therapeutic approaches for chronic constipation in pediatric patients with CP.
- To evaluate the effectiveness of polyethylene glycol (PEG) alone, Motilium alone, and a combination of PEG and Motilium.
Main Methods:
- A randomized clinical trial (RCT) involving pediatric CP patients with chronic constipation.
- Participants were divided into three groups receiving polyethylene glycol (PEG), PEG plus Motilium, or Motilium.
- Treatment duration was two weeks, with specific dosages for PEG (0.5 g/kg/dose) and Motilium (0.2 mg/kg/dose) administered thrice daily.
Main Results:
- The combination therapy (PEG plus Motilium) demonstrated the highest rate of improvement in chronic constipation.
- Satisfactory response rates were 58.8% for PEG alone, 94.4% for PEG plus Motilium, and 6.6% for Motilium alone.
- A statistically significant difference (p < 0.001) was observed between the treatment groups.
Conclusions:
- Simultaneous administration of PEG and Motilium yielded the most favorable therapeutic outcome for chronic constipation in children with CP.
- Motilium monotherapy proved to be largely ineffective.
- PEG monotherapy provided a moderate therapeutic effect, but was less effective than the combination therapy.
Introduction:
Cerebral palsy (CP) is a permanent non-progressive movement disorder, which is due to brain injuries during brain development. Constipation is one of the prevalent conditions in children with CP that can adversely affect the psychological health, appetite, and overall health of these patients.
Aim:
To compare three therapeutic methods in the treatment of chronic constipation in CP children.
Material And Methods:
In this randomised clinical trial (RCT), paediatric CP patients with chronic constipation were randomly divided into three groups (groups A, B, and C). Group A received polyethylene glycol (PEG), group B received PEG with Motilium, and group C received Motilium for 2 weeks. Motilium was administered at 0.2 mg/kg/dose and PEG at 0.5 g/kg/dose three times daily. To compare the therapeutic effect the McNemar test was used and a significance level of 0.05 was considered.
Results:
The highest rate of improvement in chronic constipation was seen in group B and the lowest rate belonged to group C. Satisfactory response frequency was seen in 10 patients in group A (58.8%), 17 patients in group B (94.4%), and 1 patient in group C (6.6%); p < 0.001.
Conclusions:
According to the findings, simultaneous use of PEG and Motilium had the best therapeutic effect for chronic constipation among CP children. However, Motilium alone was nearly ineffective, and PEG alone had a moderate therapeutic effect.
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