27926
document
A controlled , randomized , double-blind trial to evaluate the effect of a supplement of cocoa husk that is rich in dietary fiber on colonic transit in constipated pediatric patients . OBJECTIVE Although a diet that is rich in fiber is widely recommended for preventing and treating constipation , the efficacy of fiber supplements have not been tested sufficiently in children . Our aim with this pilot study was to evaluate if fiber supplementation is beneficial for the treatment of children with idiopathic chronic constipation . METHODS Using a parallel , randomized , double-blind , controlled trial , we conducted an interventional study to evaluate the efficacy of a supplement of cocoa husk rich in dietary fiber on intestinal transit time and other indices of constipation in children with constipation . After screening , the patients were randomly allocated to receive , for a period of 4 weeks , either a cocoa husk supplement or placebo plus standardized toilet training procedures . Before and after 4 weeks of treatment , we ( 1 ) performed anthropometry , a physical examination , and routine laboratory measurements , ( 2 ) determined total and segmental colonic transit time , ( 3 ) evaluated bowel movement habits and stool consistency using a diary , and ( 4 ) received a subjective evaluation from the parents regarding the efficacy of the treatment . The main variable for verifying the efficacy of the treatment was the total colonic transit time . RESULTS Fifty-six chronically constipated children were randomly assigned into the study , but only 48 children completed it . These children , who were aged between 3 and 10 years , had a diagnosis of chronic idiopathic constipation . With respect to total , partial colon , and rectum transit time , there seemed to be a trend , although statistically nonsignificant , toward faster transit times in the cocoa husk group than in the placebo group . When we analyzed the evolution of the intestinal transit time throughout the study of children whose total basal intestinal transit time was > 50th percentile , significant differences were observed between the groups . The total transit time decreased by 45.4 +/- 38.4 hours in the cocoa husk group and by 8.7 +/- 28.9 hours in the placebo group ( -38.1 hours ) . In the case of the right colon , changes in transit time also were significant between groups . Mean changes tended toward faster transit times in the left colon and the rectum , although the differences were not statistically significant . The children who received cocoa husk supplements tended to increase the number of bowel movements by more than that of the children of the placebo group . We also observed a reduction in the percentage of patients who reported hard stools ( hard scybalous or pebble-like stools ) , although this reduction was significantly greater in the cocoa husk group . At the end of the intervention , 41.7 % and 75.0 % of the patients who received cocoa husk supplementation or placebo , respectively , reported having hard stools . Moreover , a significantly higher number of children ( or their parents ) reported a subjective improvement in stool consistency . No significant adverse effects were reported during the study . CONCLUSIONS This study confirms the beneficial effect of a supplement of cocoa husk that is rich in dietary fiber on chronic idiopathic constipation in children . These benefits seem to be more evident in pediatric constipated patients with slow colonic transit time .
27927
Intervention_Pharmacological
supplement of cocoa husk that is rich in dietary fiber
27928
Intervention_Pharmacological
supplement of cocoa husk rich in dietary fiber
27929
Intervention_Physical
cocoa husk supplement or
27930
Intervention_Control
placebo plus standardized toilet training procedures
27931
Intervention_Physical
.
27932
Intervention_Physical
anthropometry
27933
Intervention_Pharmacological
cocoa husk supplements
27934
Intervention_Pharmacological
supplement of cocoa husk
27935
Outcome_Physical
colonic transit
27936
Outcome_Physical
idiopathic chronic constipation
27937
Outcome_Physical
constipation
27938
Outcome_Physical
total colonic transit time
27939
Outcome_Physical
total , partial colon , and rectum transit time
27940
Outcome_Physical
transit times
27941
Outcome_Physical
intestinal transit
27942
Outcome_Physical
basal intestinal transit time
27943
Outcome_Physical
total transit time
27944
Outcome_Physical
changes in transit time
27945
Outcome_Physical
Mean changes
27946
Outcome_Physical
number of bowel movements
27947
Outcome_Physical
hard scybalous or pebble-like stools
27948
Outcome_Physical
reported having hard stools
27949
Outcome_Physical
improvement in stool consistency
27950
Outcome_Adverse-effects
No significant adverse effects
27951
Outcome_Physical
chronic idiopathic constipation
27952
Participant_Condition
constipated
27953
Participant_Age
pediatric
27954
Participant_Condition
patients .
27955
Participant_Age
children
27956
Participant_Condition
children with constipation .
27957
Participant_Sample-size
Fifty-six
27958
Participant_Condition
chronically constipated children were randomly assigned into the study , but only
27959
Participant_Sample-size
48
27960
Participant_Condition
children completed it .
27961
Participant_Age
3 and 10 years
27962
Participant_Condition
chronic idiopathic constipation