Prevalence and clinical manifestations of constipation in children with cerebral palsy and comparison of the therapeutic effectiveness of polyethylene glycol with lactulose

Abstract

Cerebral palsy is the most common motor disability in childhood. Children with generalized cerebral palsy often suffer from comorbidities among which constipation is common. The prevalence of constipation in children with cerebral palsy depends on the definition of constipation, the diagnostic method, and how patients are selected. The treatment is associated with a lot of challenges and difficulties. The purpose of this study is to determine prevalence and clinical manifestations of constipation in children with cerebral palsy and to compare the therapeutic effectiveness of polyethylene glycol vs lactulose. Methodology and Materials: In this study, during a period of 12 months, all children aged 1-15 years with cerebral palsy who were referred to the outpatient clinic of Tabriz Children's hospital or the specialized clinic of Tabriz University of Medical Sciences after taking a detailed history in case of constipation criteria, entered the study. Diagnosing constipation based on clinical examination and according to Rome IV criteria was proposed by a pediatric gastroenterologist. The diagnosis of CP was made by a pediatric neurologist after a clinical and, if necessary, a paraclinical examination. After obtaining parental consent, the participants were divided into two groups, 1(PEG) and 2(lactulose). Results: A total of 48 patients (26 male, 54%) completed the study. A significant increase in defecation frequency and a significant decrease in encopresis frequency was found in both groups at 12 and 24 weeks of treatment. Success rate was significantly higher for PEG group (62%) compared to the lactulose group (37%). There were no serious adverse events recorded during the study. Patients receiving PEG reported less abdominal pain, bloating, nausea and vomiting. However, bad palatability and diarrhea were reported with more frequency in this group.