The effect of cassia fistula emulsion on pediatric functional constipation in comparison with mineral oil: a randomized, clinical trial

Abstract

BackgroundThe prevalence of Pediatric Functional Constipation (FC) has been reported between 0.7% to 29.6%. This study was conducted to compare the laxative effect of cassia fistula emulsion (CFE) with mineral oil (MO) on FC. Cassia fistula is named in Traditional Iranian Medicine (TIM) as “Folus”.Materials and methodsA randomized clinical trial was carried on 81 children (age range: 4–13 years) with FC, according to Rome III criteria in Amirkola Children’s Hospital, Babol, Iran. They received CFE or MO randomly for three weeks. CFE was produced according to the order of TIM references. Children were counted as improved when they exited from Rome III criteria of FC. Frequency of defecation, fecal incontinence, retentive posturing, severity of pain, consistency of stool and anal leakage of oily material were compared between the two groups and with baselines. An intent-to-treat analysis was used. Safety of drugs was assessed with the evaluation of clinical adverse effects.Results41 children were assigned randomly to receive CFE and 40 children received MO. After three weeks of medication, 84% of children in CFE group and 50% in MO group (p = 0.002) exited from the criteria of FC, so called improved. All measurable criteria improved in both groups. The frequency of defecation in CFE group improved from 1.7 per week (before the study) to 10.6 per week (at the third week) while this parameter differed in MO group from 2 to 6.1 (p < 0.001). The severity of pain during defecation and consistency of stool improved significantly better in CFE group than MO group (p < 0.05), but there were not any significant differences between the two groups in fecal incontinence and retentive posturing. Anal leakage of oily material occurred as an important complication in MO group while the children in CFE group did not complaint it. Drug’s compliances were not significantly different in the two groups. CFE and MO did not cause clinically significant side effects.ConclusionsCFE was most effective than MO in the 3-week treatment of children with FC.

Heart palpitation relief with Melissa officinalis leaf extract: Double blind, randomized, placebo controlled trial of efficacy and safety

“…Traditional Iranian Medicine (TIM) roots back to nearly 10,000 years ago (Rezaeizadeh et al, 2009), and it has a great potential for solving some of the present medical problems, as shown in some recent research in the field (Asghari et al, 2013;Faridi et al, 2014;Mokaberinejad et al, 2012;Mozaffarpur et al, 2012). As far as palpitation is concerned, it has been explained thoroughly in TIM and various therapies have been suggested for it (Ershadifar et al, 2014).…”

Constipation and Laxative Herbs in Iranian Traditional Medicine

“…For some of these herbs, their pharmacological effects are explained in detail, such as Ficuscarica (15), Rosa damascenna (16), and Viola odorata (17); some have been used as a laxative in folklore medicine or other traditional medicine, such as those of the Greeks, Romans, and Egyptians, including Alhagi mannifera (18), Linnium usitatissimum (19), and Malva sylvestris (20). Some of these plants are mentioned as a laxative in different articles, such as Aloe species (21), Cassia angustifolia (22), Cassia fistula (23), Cordia myxa (24), Olea europaea (25), Plantago ovate (26), and Prunus domestica (27). Additionally, anthraquinone, which has a laxative effect, is considered to be a heating agent in plants with hot temperaments, such as Cassia fistula (23,28).…”

“…Some of these plants are mentioned as a laxative in different articles, such as Aloe species (21), Cassia angustifolia (22), Cassia fistula (23), Cordia myxa (24), Olea europaea (25), Plantago ovate (26), and Prunus domestica (27). Additionally, anthraquinone, which has a laxative effect, is considered to be a heating agent in plants with hot temperaments, such as Cassia fistula (23,28).…”

Formulation and Evaluation of an Iranian Traditional Dosage Form Containing Linum and Ficus for Improvement of Functional Constipation

“…The inclusion criteria were less than two defecation weekly, more than one fecal incontinence per week, retentive posturing or excessive volitional stool retention, feeling of painful or hard bowel movements, presence of a large fecal mass in the rectum or large diameter stools. These criteria were according to Rome III criteria of functional constipation (25). The exclusion criteria were consumption of fermented foods or intestinal medicines except in an emergency case.…”