Gut. 1993 Oct;34(10):1400-4.
Constipation in early childhood: patient characteristics, treatment, and longterm follow up.
Department of Pediatrics, University of Iowa, Iowa City 52242-1083.
Little is known about chronic constipation in infants, toddlers, and preschool children and longterm outcome after treatment. The symptoms of 174 children < or = 4 years of age, who were evaluated for chronic constipation, are reported in this study together with the long-term outcome in 90 of them. Initial symptoms were infrequent bowel movements in 58%, painful bowel movements in 77% often with screaming, and severe stool withholding manoeuvres in 97%. The treatment of chronic idiopathic constipation consisted of education, faecal disimpaction, prevention of future impaction, and promotion of regular bowel habits with dietary fibre and milk of magnesia, and finally toilet training of the preschool child. Longterm outcome could be evaluated in 90 patients (52%) (mean (SD) 6.9 (2.7)) years after initial evaluation. Fifty seven children (63%) had recovered, defined as no soiling with > or = 3 bowel movements per week, while not receiving treatment. The recovery rate of children < or = 2 years of age was significantly higher than in children > 2 to 4 years of age. Thirty three children (37%) had not recovered. Constipation recurred as soon as laxatives were discontinued in 31 (94%) of them. Laxatives were still used by 33% of the children who had not recovered, 39% had < 3 bowel movements per week, 48% had faecal soiling, 45% had stool withholding, 27% complained of abdominal pain, 73% passed large stools, and 45% still on occasions clogged the toilet with their large stools. Symptoms of chronic constipation persisted in one third of our patients, 3-12 years after initial evaluation and treatment. Children who had not recovered deserve continued follow up, to reinforce and adjust treatment and to prevent faecal soiling.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8244110&dopt=Abstract constipation laxative [PubMed - indexed for
Int J Eat Disord. 1993 Nov;14(3):375-8.
Prevalence of self-induced vomiting and laxative/medication abuse among female adolescents: a longitudinal study.
Phelps L, Andrea R, Rizzo FG, Johnston L, Main CM.
School psychology program, State University of New York at Buffalo.
In order to assess the prevalence and stability of weight reduction techniques utilized by adolescent females, three comprehensive samples of middle school and high school students (ages 12-18) were surveyed in the springs of 1984, 1989, and 1992. All participants were enrolled in the same school district to ensure that the groups were demographically equivalent. The results demonstrated a significant decrease in the use of appetite suppressants among high school students. However, middle school females reported a significant increase in medication use and self-induced vomiting during the same 7-year period. Laxative abuse has persisted unchanged for a small segment of both populations.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8275074&dopt=Abstract constipation laxative
J Am Geriatr Soc. 1994 Jan;42(1):50-6.
Use of laxative medication in older persons and associations with low serum albumin.
Pahor M, Guralnik JM, Chrischilles EA, Wallace RB.
Cattedra di Gerontologia, Universita Cattolica del Sacro Cuore, Rome, Italy.
OBJECTIVE: To study laxative use among older persons and the association of laxative intake with hypoalbuminemia. DESIGN: Cross-sectional study in a population-based cohort. SETTING: Community and institutions in the Iowa and Washington counties, Iowa site of the Established Populations for Epidemiologic Studies of the Elderly. PARTICIPANTS: Persons aged 71 years or older, who were interviewed at the 6th year of follow-up and for whom drug intake information was obtained (n = 2,529). MAIN OUTCOME MEASURES: Laxative medication use and prevalence of hypoalbuminemia. RESULTS: The prevalence rate of laxative use was 8.8% in the community and 74.6% in nursing homes. Increasing age was independently associated with laxative use (odds ratio [OR] = 1.66, 95% confidence interval [CI] = 1.33 to 2.07 for a 10-year increase), after adjusting for gender, institutionalization, disability in activities of daily living, body mass index, and use of the following drugs: furosemide, benzodiazepines, antidepressants, codeine, and calcium antagonists. Laxative use was independently associated with hypoalbuminemia (OR = 3.17, 95% CI = 1.42 to 7.08) after adjusting for age, gender, anemia, number of comorbid conditions, disability in activities of daily living, body mass index, use of furosemide, and institutionalization status. Compared with those who never used laxatives, those who took laxatives only at the 6th year of follow-up were at increased risk of hypoalbuminemia (OR = 2.65, 95% CI = 1.04 to 6.77), and those who used laxatives at both the 3rd and 6th years of follow-up were at greatest risk (OR = 4.02, 95% CI = 1.53 to 10.06). CONCLUSION: Laxatives are used by large numbers of older persons, and the investigation on unknown adverse effects is important. P
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