Superiority of mosapride citrate to picosulfate sodium as a laxative for withdrawal from regular enemas in children with severe functional constipation

Yoshimitsu Fujii, Eriko Kouhata, K. Kaneko
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Abstract

Background: Severe functional constipation (FC) with low bowel movement frequency (BMF) of ?1 day/week and hard stools oftenrequires regularly repeated enemas or often leads to enema dependency (ED). Aim: The current study aimed to compare the efficacy of mosapride citrate (Mo) with the traditional stimulant laxative picosulfate sodium (Pi) for withdrawal from ED in children with severe FC. Results: Twenty-four treatment-naïve patients who met the Rome IV diagnostic criteria for FC seen at our center for 8 years from 2012 were enrolled. Glycerin enema was repeated until the BMF was ?3.5 days/week. Simultaneously, Mo at 0.3 mg/kg/day (n=11) or Pi at 0.25 mg/kg/day (n=13) was administered concomitantly with magnesium oxide or lactulose. The proportion of withdrawal from ED was significantly higher in the Mo group than Pi group during the 4 months observational period (90.9% vs. 46.2%, respectively; p=0.034) and shorter in time to withdraw from ED (0 vs. 3.5 months, respectively; p=0.015). Conclusion: Mo is more effective than Pi for withdrawal from ED in children with severe FC.
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枸橼酸莫沙必利对picosulfate钠作为一种轻泻剂在严重功能性便秘儿童从常规灌肠中退出的优越性
背景:严重的功能性便秘(FC)伴低肠蠕动频率(BMF)为每周1天,并且大便坚硬,经常需要定期重复灌肠或经常导致灌肠依赖(ED)。目的:本研究旨在比较枸橼酸莫沙匹利(Mo)与传统的兴奋剂泻药picosulfate sodium (Pi)对重度FC患儿退出ED的疗效。结果:从2012年起8年间在我中心就诊的24例treatment-naïve患者符合FC的Rome IV诊断标准。反复进行甘油灌肠,直至BMF达到3.5天/周。同时,Mo 0.3 mg/kg/day (n=11)或Pi 0.25 mg/kg/day (n=13)与氧化镁或乳果糖同时施用。在4个月的观察期内,Mo组退出ED的比例显著高于Pi组(分别为90.9%和46.2%;p=0.034),且退出ED的时间更短(分别为0个月和3.5个月;p = 0.015)。结论:莫替尼对重度FC患儿ED的戒断效果优于皮替尼。
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