Utility of Mosapride Citrate in Pediatric Functional Constipation with Low Bowel Movement Frequency

Abstract

Functional constipation (FC) in children often requires medical treatment, including pharmacotherapy. Conventional laxatives such as magnesium oxide, sodium picosulfate, lactulose, and carmellose sodium have been used for many years. However, these drugs are often ineffective for patients with intractable FC, requiring continual transanal treatments such as glycerin enemas or bisacodyl suppositories. Mosapride citrate (Mc), a 5-HT4-receptor agonist, is a prokinetic agent that is useful for functional dyspepsia [1]. Symptoms of FD are epigastric discomfort, bloating, appetite loss, pain, or nausea. We administered Mc to pediatric FC patients with the symptoms of functional dyspepsia. This empiric treatment of some patients resulted in significant improvement in bowel movements. In this retrospective study, we assess the effectiveness of Mc combined with the conventional laxatives for FC in a pediatric population. To our knowledge, this

Utility of Mosapride Citrate Combined With Osmotic Laxatives and Probiotics in the Initial Treatment of Pediatric Functional Constipation

“…One limitation of this study was that Mc was not compared with other treatments for FC. A comparison between Mc only and the basal treatment of probiotics and osmotic laxatives was not permitted ethically because the basal treatment should be ineffective for severe FC according to the previous reports (3,6,8,9). However, the duration of Mc treatment did not exceed the treatment duration in previous studies (8,9).…”

“…Conventional laxatives (CLs) such as magnesium oxide (Mo), sodium picosulfate, lactulose, and carmellose sodium have long been used to treat FC. However, these drugs are often ineffective in patients with severe FC, requiring continual transanal treatments such as glycerin enema (GE) (3).…”

Superiority of mosapride citrate to picosulfate sodium as a laxative for withdrawal from regular enemas in children with severe functional constipation

“…Indian J Child Health 2 throughout the treatment period [9,10], while the patients in the Pi group received Pi at an initial dose of 0.25 mg/kg/day from the 3 rd day after the first visit. This is because Pi may cause abdominal pain due to forced hyperperistalsis in patients with fecal impaction.…”

“…ED: >50% of defecations induced by GEs during the most recent 4-week period. Assessments related to therapeutic efficacy were defined as follows [2,4,9,10,15]; BMF: The number of days per week on which defecation was achieved without a GE; treatment success (TS): BMF of ≥3 and BSFS of ≥3 without meeting the Rome diagnostic criteria for pediatric FC during 4 weeks; WE: Maintenance of TS without GEs; the time to WE: The number of days between the initial and final GE; and failure of WE: Failure to achieve TS despite 4 months of GE treatment.…”

“…Mosapride citrate (Mo) [9][10][11] was recently added to the list of drugs for the treatment of severe FC in children [2]. Mo is a stimulant laxative that modulates physiological peristalsis of the gastrointestinal tract [11] and has been used in children with reflux esophagitis [12] without adverse events, even with long periods of administration [13].…”