Evaluation of Pena Protocol for Bowel Management in Children with Chronic Constipation | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 66, Volume 98, Issue 1, January 2025, Pages 453-459 PDF (549.15 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2025.406361 | ||
| Abstract | ||
| Background: Chronic constipation is one of the most common chronic disorders of childhood, affecting 1% to 30% of children worldwide. Aim: To evaluate the efficacy and feasibility of Pena protocol of bowel management in children with chronic constipation Patients and methods: This prospective cross-sectional study was conducted on 63 children with chronic constipation in the Pediatric Unit of General Surgery Department at Benha University Hospital Results: Regarding the final outcome of Pena protocol for management of chronic constipation, the majority of cases had good response (93.7%) while 4 cases still had no response and needed surgery. According to the first step of Pena management among studied cases, which is enema, only 3 cases had antegrade enema and the majority had retrograde enema (95.2%) with mean dose of enema of 735, ranged from 200 to 1000 ml. For content of enema, one third used saline solution, also one third used glycerin, then 23.8% used phosphate, while 3 cases only used Castile soap, and another 3 cases used polyethylene glycol. Regarding the management by laxatives, 34.9% needed laxatives either due to increased number of enemas or increased dose with the majority used bulk forming laxative (59.1%), while osmotic and stool softener laxatives were used in 18.25 and 22.7%, respectively, among cases who used laxatives. Conclusion: Pena protocol is effective and well-tolerated for bowel management in children with chronic constipation. Therefore, rectal enemas and oral laxatives should be equally considered as the first line therapy. | ||
| Keywords | ||
| Chronic constipation; Pena protocol; Rectal enemas; Laxatives | ||
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