Factors Impacting Laxative Use in Children and Adolescents With Epidermolysis Bullosa: Single Centre Retrospective...

Epidermolysis bullosa (EB) is characterised by chronic cutaneous wounds and gastrointestinal complications, including constipation. Aim to identify factors that impacted stool frequency and laxative use in paediatric patients with severe subtypes of EB.

Retrospective data collection on demographics, type of EB, total fibre intake (food, enteral formula and supplements), probiotic supplementation, laxative use, iron supplementation, opioid-based pain medication, stool consistency and frequency using the Bristol Stool Chart.

Data collected on 37 patients. The mean total fibre intake was 16.67 g/day (10.67 SD). Twenty-seven of 37 (73%) children were on macrogol osmotic laxatives. Children who were taking fibre supplementation were also more likely to be on macrogol compared to children not taking fibre supplementation (p = 0.047). No significant association was found between total fibre intake g/day or fibre reference nutrient intake (%) on stool consistency, r = -0.04 and r = -0.3, respectively. Children taking iron supplements were more likely to take macrogol compared to children not on iron supplements. Eight of 37 patients were on regular probiotics, but there was not a significant reduction in the need for macrogol osmotic laxatives compared to children not taking probiotics (χ² 0.025, p-value 0.87).

Patients who were on fibre supplementation were also more likely to take laxatives. Patients on iron supplements had a greater reliance on laxatives than those patients not taking iron supplements, further demonstrating the impact iron has within the intestines. The potential benefits of probiotics in the management of constipation may be suppressed in children with EB due to regular antibiotic administration.