vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v11i3.309vsp-495Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCEЗАПОРЫ У ДЕТЕЙCONSTIPATIONS IN CHILDRENПолищукА. Р.PolishchukA. R.erdes@mma.ruЭрдесС. И.ErdesS. I.

Erdes Svetlana Il’inichna, PhD, professor, Head of the Department of Propedeutics of Child Diseases of Pediatric Faculty

erdes@mma.ruМацукатоваБ. О.MatsukatovaB. O.erdes@mma.ruПервый Московский государственный медицинский университет им. И.М. СеченоваРоссияI.M. Setchenov First Moscow State Medical UniversityRussian Federation201217052012113Вопросы современной педиатрии112115Copyright © Полищук А.Р., Эрдес С.И., Мацукатова Б.О., 20122012Полищук А.Р., Эрдес С.И., Мацукатова Б.О.Polishchuk A.R., Erdes S.I., Matsukatova B.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/495

Обсуждаются вопросы эпидемиологии запоров у детей, осложнений при них, некоторые положения зарубежных согласительных рекомендаций. Приводятся данные о распространенности этой формы патологии в различных странах. Указывается на важность учета клинических проявлений, которые могут свидетельствовать о наличии органической патологии. Обращается внимание на возрастные особенности формирования запоров у детей. Обсуждены механизмы и особенности действия лактулозы, показания и противопоказания для ее применения. Приводятся данные рандомизированных клинических исследований.

запоры у детейлактулозаconstipationchildrenlactuloseReferencesЦимбалова Е. Г., Потапов А. С., Баранов К. Н. Хронические запоры у детей. Вопросы современной педиатрии. 2002; 1 (6): 56–61.Цимбалова Е. Г., Потапов А. С., Баранов К. Н. Хронические запоры у детей. Вопросы современной педиатрии. 2002; 1 (6): 56–61.Хавкин А. И. Функциональные нарушения желудочно-кишечного тракта у детей раннего возраста. М.: Правда. 2000. 72 с.Хавкин А. И. Функциональные нарушения желудочно-кишечного тракта у детей раннего возраста. М.: Правда. 2000. 72 с.Loening-Baucke V. Prevalence rates for constipation and faecal and urinary incontinence. Arch. Dis. Child. 2007; 92 (6): 486–489.Loening-Baucke V. Prevalence rates for constipation and faecal and urinary incontinence. Arch. Dis. Child. 2007; 92 (6): 486–489.Saps M., Sztainberg M., Di Lorenzo C. A prospective communitybased study of gastroenterological symptoms in school-age children. J. Pediatr. Gastroenterol. Nutr. 2006; 43 (4): 477–482.Saps M., Sztainberg M., Di Lorenzo C. A prospective communitybased study of gastroenterological symptoms in school-age children. J. Pediatr. Gastroenterol. Nutr. 2006; 43 (4): 477–482.Yong D., Beattie R. M. Normal bowel habit and prevalence of constipation in primary-school children. Ambulatory Child. Health. 1998; 4: 277–282.Yong D., Beattie R. M. Normal bowel habit and prevalence of constipation in primary-school children. Ambulatory Child. Health. 1998; 4: 277–282.Ludvigsson J. F. Epidemiological study of constipation and other gastrointestinal symptoms in 8000 children. Acta Paediatrica. 2006; 95 (5): 573–580.Ludvigsson J. F. Epidemiological study of constipation and other gastrointestinal symptoms in 8000 children. Acta Paediatrica. 2006; 95 (5): 573–580.de Araujo Sant Anna A. M., Calcado A. C. Constipation in schoolaged children at public schools in Rio de Janeiro, Brazil. J. Pediatr. Gastroenterol. Nutr. 1999; 29 (2): 190–193.de Araujo Sant Anna A. M., Calcado A. C. Constipation in schoolaged children at public schools in Rio de Janeiro, Brazil. J. Pediatr. Gastroenterol. Nutr. 1999; 29 (2): 190–193.Rajindrajith S., Devanarayana N. M., Mettananda S. et al. Constipation and functional faecal retention in a group of school children in a district in Sri Lanka. J. Child. Health. 2009; 38: 60–64.Rajindrajith S., Devanarayana N. M., Mettananda S. et al. Constipation and functional faecal retention in a group of school children in a district in Sri Lanka. J. Child. Health. 2009; 38: 60–64.Constipation and Soiling in Children. Guideline Team. University of Michigan Health System. Functional. UMHS functional constipation and soiling guideline. Ann. Arbor. 2003.Constipation and Soiling in Children. Guideline Team. University of Michigan Health System. Functional. UMHS functional constipation and soiling guideline. Ann. Arbor. 2003.Constipation in children and young people. Diagnosis and management of idiopathic childhood constipation in primary and secondary care. NICE clinical guideline 99. Developed by the National Collaborating Centre for Women’s and Children’s Health. London. 2010.Constipation in children and young people. Diagnosis and management of idiopathic childhood constipation in primary and secondary care. NICE clinical guideline 99. Developed by the National Collaborating Centre for Women’s and Children’s Health. London. 2010.Evaluation and Treatment of Constipation in Infants and Children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. JPGN. 2006; 43: e1–e13.Evaluation and Treatment of Constipation in Infants and Children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. JPGN. 2006; 43: e1–e13.Montgomery E., Hudson C. S. Transformation of lactose to a new disaccharide, lactoketose. Science. 1929; 69: 556–557.Montgomery E., Hudson C. S. Transformation of lactose to a new disaccharide, lactoketose. Science. 1929; 69: 556–557.Mayerhofer F., Petuely F. Untersuchungenzur Regulation der Darmtrdgheit des ErwachsenenmitHilfe der Lactulose (Bifidus- Faktor). Wien. Klin. Wochenschr. 1959; 71: 865–869.Mayerhofer F., Petuely F. Untersuchungenzur Regulation der Darmtrdgheit des ErwachsenenmitHilfe der Lactulose (Bifidus- Faktor). Wien. Klin. Wochenschr. 1959; 71: 865–869.Menzies I. S., Pounder R., Heyer S. et al. Abnormal intestinal permeability to sugars in villous atrophy. Lancet. 1979; 2: 1107–1109.Menzies I. S., Pounder R., Heyer S. et al. Abnormal intestinal permeability to sugars in villous atrophy. Lancet. 1979; 2: 1107–1109.Managing Constipation in Children. DTB. 2000; 38 (8): 57–60.Managing Constipation in Children. DTB. 2000; 38 (8): 57–60.Bush R. T. Lactulose: An ideal laxative for children. NZ. Med. J. 1970; 71: 364–365.Bush R. T. Lactulose: An ideal laxative for children. NZ. Med. J. 1970; 71: 364–365.Engelhardt F., Schreier K. Lactulose in der Behandlung der Sduglings und Kleinkinderobstipation. Med. Erndhr. 1972; 13: 124–125.Engelhardt F., Schreier K. Lactulose in der Behandlung der Sduglings und Kleinkinderobstipation. Med. Erndhr. 1972; 13: 124–125.Muller M., Jaquenoud-Sirot E. Behandlung der chronischen Obstipation bei Kindernmit Lactulose. Ars. Medici. 1994; 84: 568–74.Muller M., Jaquenoud-Sirot E. Behandlung der chronischen Obstipation bei Kindernmit Lactulose. Ars. Medici. 1994; 84: 568–74.Palmie P. E. ZurBehandlung der Obstipation imKindes- und Jugendalter. Therapiewoche. 1980; 30: 4045–4049.Palmie P. E. ZurBehandlung der Obstipation imKindes- und Jugendalter. Therapiewoche. 1980; 30: 4045–4049.Perkin J. M. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr. Med. Res. Opin. 1977; 4: 540–543.Perkin J. M. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr. Med. Res. Opin. 1977; 4: 540–543.Von Klinggrdff C. ZurTherapie der Obstipation beiKleinkindern, Kindern und Jugendlichen. Kinderarzt. 1981; 6: 1–3.Von Klinggrdff C. ZurTherapie der Obstipation beiKleinkindern, Kindern und Jugendlichen. Kinderarzt. 1981; 6: 1–3.Gleason W., Figueroa-Colon R., Robinson L. H. et al. A doubleblind, parallel-group, placebo-controlled study of lactu-lose in the treatment of encopresis in children with chronic constipation. Gastroenterol. 1995; 108 (Suppl. 4): A606.Gleason W., Figueroa-Colon R., Robinson L. H. et al. A doubleblind, parallel-group, placebo-controlled study of lactu-lose in the treatment of encopresis in children with chronic constipation. Gastroenterol. 1995; 108 (Suppl. 4): A606.Ghisolfi J. Dietary fibre and prebiotics in infant formulas. The Proceedings of the Nutrition Society. 2003; 62 (1): 183–185.Ghisolfi J. Dietary fibre and prebiotics in infant formulas. The Proceedings of the Nutrition Society. 2003; 62 (1): 183–185.Aggett P. J., Agostoni C., Axelsson I. et al. Nondigestible carbohydrates in the diets of infants and young children: A commentary by the ESPGHAN Committee on Nutrition. Journal of pediatric gastroenterology and nutrition. 2003; 36 (3): 329–337.Aggett P. J., Agostoni C., Axelsson I. et al. Nondigestible carbohydrates in the diets of infants and young children: A commentary by the ESPGHAN Committee on Nutrition. Journal of pediatric gastroenterology and nutrition. 2003; 36 (3): 329–337.Schumann C. Medical, nutritional and technological properties of lactulose. Anupdate. Eur. J. Nutr. 2002; 41 (Suppl. 1): 17–25.Schumann C. Medical, nutritional and technological properties of lactulose. Anupdate. Eur. J. Nutr. 2002; 41 (Suppl. 1): 17–25.Haschke F., Firmansyah A., Meng M. et al. Functional food for infants and children; FunktionelleSaeuglings und Kindernahrung. Monatsschrift Kinderheilkunde — Organ der Deutschen Gesellschaftfuer Kinderheilkunde und Jugendmedizin. 2001; 149 (13): 66–70.Haschke F., Firmansyah A., Meng M. et al. Functional food for infants and children; FunktionelleSaeuglings und Kindernahrung. Monatsschrift Kinderheilkunde — Organ der Deutschen Gesellschaftfuer Kinderheilkunde und Jugendmedizin. 2001; 149 (13): 66–70.Marini A., Negretti F., Boehm G. Pro- and pre-biotics administration in preterm infants: colonization and influence on faecal flora. Actapaediatrica. 2003; 91 (441): 80–81.Marini A., Negretti F., Boehm G. Pro- and pre-biotics administration in preterm infants: colonization and influence on faecal flora. Actapaediatrica. 2003; 91 (441): 80–81.Kokke F. A Dietary Fiber Mixture versus Lactulose in the Treatment of Childhood Constipation: A Double-blind Randomized Controlled Trial. JPGN. 2008; 47 (5): 592–597.Kokke F. A Dietary Fiber Mixture versus Lactulose in the Treatment of Childhood Constipation: A Double-blind Randomized Controlled Trial. JPGN. 2008; 47 (5): 592–597.Connolly P. Comparison of ‘Duphalac’ and ‘irritant’ laxatives during and after treatment of chronic constipation: a preliminary study. Curr. Med. Res. Opin. 1975; 2 (10): 620–625.Connolly P. Comparison of ‘Duphalac’ and ‘irritant’ laxatives during and after treatment of chronic constipation: a preliminary study. Curr. Med. Res. Opin. 1975; 2 (10): 620–625.

The authors declare that there are no conflicts of interest present.