Pharmacological Strategies for High-Output Ileostomies in Children: A Narrative Review

IF 2.1 4区医学 Q1 PEDIATRICS Acta Paediatrica Pub Date : 2025-01-22 DOI:10.1111/apa.17587

Marijke Awouters, Tim Vanuytsel, Pauline De Bruyne, Karen van Hoeve, Ilse Hoffman

{"title":"Pharmacological Strategies for High-Output Ileostomies in Children: A Narrative Review","authors":"Marijke Awouters, Tim Vanuytsel, Pauline De Bruyne, Karen van Hoeve, Ilse Hoffman","doi":"10.1111/apa.17587","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>Nutritional measures often suffice for managing high-output ileostomy (HOI) in paediatric patients, but pharmacological treatment may be required to control ostomy output. This paper reviews the literature on the pharmacological management of paediatric HOI and provides recommendations.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>PubMed and Embase were searched for relevant articles up to 22 May 2024. Relevant articles were reviewed and recommendations were formulated.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>No pharmacological studies involving paediatric ileostomy patients were identified, apart from two case reports on octreotide. The formulated recommendations are therefore based on data from adults or other intestinal failure conditions. The primary treatment suggestions are proton pump inhibitors and loperamide. Subcutaneous octreotide can be administered when complications persist. Codeine may be used in rare cases in children over 12 years old, but addiction risk and side effects limit its use. There is no or insufficient evidence for smectite, racecadotril, probiotics or prophylactic cycled antibiotics or clonidine. Bile acid sequestrants are not indicated in patients without a colon in continuity.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Pharmacological options for the treatment of HOI in children are limited and evidence for their use is lacking. Research in paediatric HOI patients is needed to validate the use of pharmacotherapy in this patient group.</p>\n </section>\n </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"114 5","pages":"806-815"},"PeriodicalIF":2.1000,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Paediatrica","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/apa.17587","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

Nutritional measures often suffice for managing high-output ileostomy (HOI) in paediatric patients, but pharmacological treatment may be required to control ostomy output. This paper reviews the literature on the pharmacological management of paediatric HOI and provides recommendations.

Methods

PubMed and Embase were searched for relevant articles up to 22 May 2024. Relevant articles were reviewed and recommendations were formulated.

Results

No pharmacological studies involving paediatric ileostomy patients were identified, apart from two case reports on octreotide. The formulated recommendations are therefore based on data from adults or other intestinal failure conditions. The primary treatment suggestions are proton pump inhibitors and loperamide. Subcutaneous octreotide can be administered when complications persist. Codeine may be used in rare cases in children over 12 years old, but addiction risk and side effects limit its use. There is no or insufficient evidence for smectite, racecadotril, probiotics or prophylactic cycled antibiotics or clonidine. Bile acid sequestrants are not indicated in patients without a colon in continuity.

Conclusion

Pharmacological options for the treatment of HOI in children are limited and evidence for their use is lacking. Research in paediatric HOI patients is needed to validate the use of pharmacotherapy in this patient group.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

儿童高输出回肠造口的药理学策略：叙述性回顾。

目的：营养措施通常足以管理高输出回肠造口（HOI）在儿科患者，但药物治疗可能需要控制造口输出。本文综述了儿科HOI的药理学管理方面的文献，并提出了建议。方法：检索截至2024年5月22日的PubMed和Embase相关文献。审查了相关文章并提出了建议。结果：除两例关于奥曲肽的报告外，未发现涉及儿童回肠造口患者的药理学研究。因此，制定的建议是基于成人或其他肠衰竭情况的数据。主要的治疗建议是质子泵抑制剂和洛哌丁胺。当并发症持续存在时，可皮下使用奥曲肽。可待因可用于12岁以上儿童的罕见病例，但成瘾风险和副作用限制了其使用。没有或不足的证据表明蒙脱石，消旋卡多曲，益生菌或预防性循环抗生素或可乐定。胆汁酸隔离剂不适用于没有连续性结肠的患者。结论：治疗儿童HOI的药物选择有限，缺乏相关证据。需要对儿科HOI患者进行研究，以验证在该患者组中使用药物治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Acta Paediatrica 医学-小儿科

CiteScore

6.50

自引率

5.30%

发文量

384

审稿时长

2-4 weeks

期刊介绍： Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including: neonatal medicine developmental medicine adolescent medicine child health and environment psychosomatic pediatrics child health in developing countries