Effect of Face-to-Face and Multimedia Methods of Education on Children’s Constipation Severity

Background: Constipation is a common problem among children. The aim of this study was to compare the effect of face-to-face and multimedia education on the severity of functional constipation in children. Methods: It was a two-group pre-test post-test quasi-experimental study that was carried out at the Specialized Clinics of Pediatrics affiliated with the Arak University of Medical Sciences, Arak, Iran. The sample consisted of 96 eligible children in the age range of 6 to 12 years that were randomly assigned to face-to-face (n=48) and multimedia (n=48) groups. Functional constipation was detected by Rome ΙΙΙ criteria. Data were collected by a demographic characteristics form and the Constipation Assessment Scale (CAS) before intervention and one month later in both groups. In the face-to-face group, education was provided using two 15-min training sessions in the form of a lecture in the presence of the mother. The multimedia training group received a 15-min training video. Both groups were given a pamphlet. The data were analyzed by Fisher’s exact test, independent t-test, and paired t-test using SPSS version 16. Results: There was no significant difference between the groups’ constipation severity before the intervention (P=0.12). There was a significant difference between the mean score of constipation severity between the face-to-face (P=0.01) and multimedia (P=0.001) groups before and after the intervention. However, the mean±SD score of constipation severity after the intervention was 7.05±1.79 in the face-to-face group and 5.91±1.69 in the multimedia group (p=0.001). Conclusion: The results of this study showed that both educational interventions reduced the severity of constipation in children. However, multimedia training was more effective than face-to-face education so that it reduced the severity of constipation to a greater extent.

Early constipation predicts faster dementia onset in Parkinson’s disease

Constipation is a common but not a universal feature in early PD, suggesting that gut involvement is heterogeneous and may be part of a distinct PD subtype with prognostic implications. We analysed data from the Parkinson’s Incidence Cohorts Collaboration, composed of incident community-based cohorts of PD patients assessed longitudinally over 8 years. Constipation was assessed with the MDS-UPDRS constipation item or a comparable categorical scale. Primary PD outcomes of interest were dementia, postural instability and death. PD patients were stratified according to constipation severity at diagnosis: none (n = 313, 67.3%), minor (n = 97, 20.9%) and major (n = 55, 11.8%). Clinical progression to all three outcomes was more rapid in those with more severe constipation at baseline (Kaplan–Meier survival analysis). Cox regression analysis, adjusting for relevant confounders, confirmed a significant relationship between constipation severity and progression to dementia, but not postural instability or death. Early constipation may predict an accelerated progression of neurodegenerative pathology.

Effectiveness of Probiotics in the Management of Functional Constipation in Children: A Randomized, Double-Blind, Placebo-Controlled Trial

A randomized, double-blind, placebo-controlled trial was conducted to assess the efficacy of probiotics (L. acidophilus, B. longum, and S. thermophylus 2 × 109 cfu/day) in 78 children aged 4–10 years old with functional constipation (Rome III criteria) at several schools in Jakarta, Indonesia. The case finding used a validated parent-report questionnaire. Subjects were randomly assigned to receive either oral probiotics (L. acidophilus, B. longum, and S. thermophylus 1 × 109 cfu/day) or placebo twice a day for 4 weeks. There were more subjects in the probiotics group who had improvement in stool consistency (P = 0.022) and difficulty/painful defecation (P = 0.009) than in the placebo group. Other symptoms (frequency of bowel movements, withholding behavior, fecal incontinence, and presence of stool mass in abdomen) also improved, but no statistically significant differences were found. Constipation severity significantly improved in the probiotics group (P = 0.026). Overall improvement (defined as decrease of constipation severity score >60% at the end of evaluation) was higher in the probiotics group than the placebo group (31/39 versus 18/39, P = 0.002) with number needed to treat (NNT) of 3 (95%CI 2;8). The present study shows that probiotics (L. acidophilus, B. longum, and S. thermophylus 2 × 109 cfu/day) are effective in the management of functional constipation in children.