Combinations of laxatives and green banana biomass on the treatment of functional constipation in children and adolescents: a randomized study Please cite this article as: Cassettari VM, Machado NC, Lourenção PL, Carvalho MA, Ortolan EV. Combinations of laxatives and green banana biomass on the treatment of functional constipation in children and adolescents: a randomized study. J Pediatr (Rio J). 2019;95:27–33.

Vanessa Mello Granado Cassettari Nilton Carlos Machado Pedro Luiz Toledo de Arruda Lourenção Marry Assis Carvalho Erika Veruska Paiva Ortolan About the authors

Abstract

Objectives:

Evaluate the effect of combinations of green banana biomass and laxatives in children and adolescents with chronic constipation.

Methods:

This was a randomized study of 80 children and adolescents with functional constipation according to the Rome IV Criteria, who were divided into five groups: (1) green banana biomass alone; (2) green banana biomass plus PEG 3350 with electrolytes; (3) green banana biomass plus sodium picosulfate; (4) PEG 3350 with electrolytes alone; and (5) sodium picosulfate alone. Primary outcome measure was the reduction of the proportion of patients with Bristol Stool Form Scale ratings 1 or 2. Secondary outcome measures were: increase of the proportion of >3 bowel movements/week and reduction of the proportion of fecal incontinence, straining on defecation, painful defecation, blood in stool, abdominal pain, and decreased laxative doses.

Results:

On consumption of green banana biomass alone, a statistically significant reduction was observed in the proportion of children with Bristol Stool Form Scale rating 1 or 2, straining on defecation, painful defecation, and abdominal pain. Conversely, no reduction was observed in fecal incontinence episodes/week, blood in stool, and no increase was observed in the proportion of children with >3 bowel movements/week. The percentage of children who required decreased laxative dose was high when green banana biomass was associated with sodium picosulfate (87%), and PEG 3350 with electrolytes (63%). Green banana biomass alone and associated with laxatives was well tolerated, and no adverse effects were reported.

Conclusion:

Green banana biomass is advantageous as an adjunct therapy on functional constipation, mainly for reducing doses of laxatives.

KEYWORDS
Constipation; Dietary fiber; Green banana; Green banana biomass; Resistant starch

Sociedade Brasileira de Pediatria Av. Carlos Gomes, 328 cj. 304, 90480-000 Porto Alegre RS Brazil, Tel.: +55 51 3328-9520 - Porto Alegre - RS - Brazil
E-mail: jped@jped.com.br