Pediatr Gastroenterol Nutr. 2024 Jan 29. doi: 10.1002/jpn3.12111. Online ahead of print.

Jana Nelson ¹, Steffi Mayer ¹, Martina P Neininger ², Astrid Bertsche ³, Martin Lacher ¹, Jan-Hendrik Gosemann ¹

Author information

¹Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany.

²Department of Clinical Pharmacy, Leipzig University and Drug Safety Center, Institute of Pharmacy, Medical Faculty, Leipzig University and University Hospital, Leipzig, Germany.

³Department of Pediatric Neurology, University Medicine Greifswald, Greifswald, Germany.

Abstract

Objectives: Complementary and alternative medicine (CAM) has gained increasing attention as a supportive treatment for chronic diseases such as epilepsy, migraine, autism, and cancer in children. This study aimed to determine the frequency, motivation, and outcomes of CAM in children with functional constipation.

Methods: From January 2018 till September 2019, parents of patients (0-18 years) who were treated for functional constipation (ROME IV-criteria) at our colorectal center were asked to complete a questionnaire on the utilization of CAM. Demographic data and clinical assessments were documented and analyzed for patients with and without CAM treatment.

Results: A total of 115 patients were included (mean age: 5.1 years; 49% males), of whom 29 (25%) used CAM as an alternative (4/29,14%) or in addition to conventional therapy (CT), including osteopathy (48%), homeopathy (45%), and natural/herbal remedies (17%). The main reason parents reported for the use of CAM was the urge to leave no treatment option unattempted (76%). Multivariate analysis also identified persistent constipation under CT (72%), adverse effects of CT (24%), and parental use of CAM themselves (83%) as independent variables associated with CAM use. Parents reported positive changes in stool frequency (38%) and fecal incontinence (21%) with CAM. The vast majority (93%) plan to use CAM in the future, and even non-CAM users showed high interest (60%).

Conclusion: One in four children with functional constipation receives CAM. Significant improvement in stool frequency and continence is missing in the majority. However, parental interest in CAM remains high. Physicians should be aware of CAM when counseling families for functional constipation in children.