Original Article Gum Arabic in treatment of functional constipation in children in Sudan

Background: Constipation represents a common problem in children. The worldwide prevalence of functional constipation in children varies from 0.7% to 29.6%.Objective: The aim of this study is to assess the response to Gum Arabic in addition to laxative in management of functional constipation.Methods: All children less than 16 years old who suffered from constipation and attended Gaafar Ibnaouf Specialized Children Hospital and gastroenterology private clinic of one pediatric gastroenterologist between June 2011 and May 2012 were included in this study. Patients were considered having functional constipation according to Rome III criteria. They were divided randomly into two similar groups. Children in the first group were treated with laxative (lactulose), and those in the second group were treated with Gum Arabic in addition to laxative (lactulose), children in both groups were educated about the process of developing constipation, defecation process and approach to toilet training. All children were seen after 1month and 3 months after treatment, they were rated as successfully treated when they had .3 bowel movements per week, soft stool, no soiling or abdominal pain in the last 3weeks of treatment.Results: A total of 150 children suffered from constipation were seen. (81males), the age was divided into three groups, the majority 96 (64 %) aged between 1-5years, and the least were 12 (8%) aged less than 1year. 133 children (88.7%) had functional constipation, while the remaining 17 children (11.3%) had an associated organic disorders, among them 12 children (8%) had Hirschsprungfs disease, 2 children (1.3%) had hypothyroidism, 2 children (1.3%) had celiac disease, and 1child (0.7%) had cerebral palsy. The main clinical characteristic of functional constipation were faecal impaction presented in 59.4% of patients, straining in 43%, withholding behavior in 32.3%, soiling in 16.5%, abdominal pain in12% of patients. In those who were treated with Gum Arabic, 41/63 (65%) showed improvement at 1st month of treatment and 59/63 (93.6%) at 3rd month of treatment, while those who were treated with laxative alone showed that 34/60(56.66%) improved at 1month of treatment and 48/60 (80%) at 3rd month, with p value <0.025Conclusions: Functional constipation is the most cause of constipation in Sudanese children. Gum Arabic achieved better results than laxative alone in treatment of functional constipation.Keywords: Hirschsprungfs disease, hypothyroidism, faecal impaction