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G11 Prucalopride for treatment refractory constipation in children: a single tertiary centre experience
Introduction/BackgroundChronic constipation is a common condition in childhood, with an estimated prevalence of 3% worldwide.1 Commonly no cause is found (idiopathic constipation) although there are a number of important aetiologies to rule out during the evaluation of children with constipation. Ph...
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| Published in: | Frontline gastroenterology 2022-04, Vol.13 (Suppl 1), p.A22-A23 |
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| Main Authors: | , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Introduction/BackgroundChronic constipation is a common condition in childhood, with an estimated prevalence of 3% worldwide.1 Commonly no cause is found (idiopathic constipation) although there are a number of important aetiologies to rule out during the evaluation of children with constipation. Pharmacological management is the mainstay of treatment, current NICE recommendations for refractory cases is for referral to surgical services for potentially more invasive therapies.2 Prucalopride is a 5-HT4 receptor agonist, it produces an enterokinetic effect to increase colonic motility. It is recommended as a treatment of refractory constipation in adult but, despite promise, there is little data supporting its use in paediatrics.4 AimTo provide a single tertiary centre experience of using Prucalopride in paediatric patients with treatment refractory constipation.Subjects and Methods5 female teenage patients (12–17yrs) average age at initiation 15yrs with treatment refractory constipation in our centre. Patients received a dose of 2mg once daily on an initial 1 month trial of treatment. Table 1 summarises the patient demographics and treatment outcomes. All patients had idiopathic constipation. 4 out of 5 (80%) had rectal biopsies that were normal. 3 out of 5 (60%) had previous transit studies with 2 out of 3 (66%) showing delayed elimination of markers. 1 out of 5 (20%) underwent manometry assessment and this was normal. 2 out of 5 (40%) patients had previous surgical therapy for their constipation with both patients undergoing an ACE procedure and 1 patient additionally receiving anal botox therapy.ResultsThere was a wide variation in reported stooling prior to commencing Prucalopride and 3 out of 5 (60%) of patients reported an improvement in stooling pattern following the commencement of Prucalopride. In patients where there was an improvement in stooling frequency, all were able to deescalate other medical therapies including reductions in rectal therapies. With regards to adverse side effects: 2 (40%) patients reported pain initially on commencing treatment, 1 (20%) patient reported headache, 1 (20%) patient reported a worsening of existing bladder instability and 1 (20%) patient reported reduction of appetite and weight loss. No patient had adverse side effects that led to the cessation of treatment.Abstract G11 Table 1Summary of patients and effects of treatment Patient Gender Diagnosis Age at diagnosis Previous Surgical management Age when started P |
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| ISSN: | 2041-4137 2041-4145 |
| DOI: | 10.1136/flgastro-2022-bspghan.30 |