Recent research has shed new light on the treatment of functional constipation among children, comparing the efficacy of Ziziphus jujube syrup with the more traditional polyethylene glycol (PEG). This study, carried out at the 17-Shahrivar Hospital’s pediatric gastroenterology department in Rasht, Iran, reveals promising results for the natural syrup as it shows greater effectiveness and fewer side effects.
Functional constipation is one of the most common gastrointestinal complaints seen in children, responsible for significant distress and inconvenience. Affecting up to 29.6% of children globally, this condition typically presents with infrequent and painful bowel movements coupled with hard stools. Standard treatments include various laxatives; PEG is often prescribed as the first line of therapy due to its relative safety and efficacy. Yet, many children experience discomfort and side effects, making the search for alternative remedies increasingly important.
This study focused on children aged 2 to 10 years diagnosed with functional constipation, who were randomized to receive either Ziziphus jujuba syrup (ZS) or PEG over 12 weeks. The double-blind trial ensures the integrity of the results, as neither the participants nor the investigators knew which treatment the children were receiving.
The results were compelling: children treated with ZS exhibited significantly improved therapeutic response scores compared to their counterparts on PEG. Specifically, the average number of encopresis episodes—a sign of fecal retention—was markedly reduced, as were pain scores measured by the visual analog scale. The therapeutic response to ZS was observed to be more favorable across all follow-up visits throughout the study, leading to the conclusion drawn by the researchers: ZS can serve as an effective treatment option for pediatric functional constipation.
Importantly, there were no adverse events or impacts on liver or kidney functions recorded among those taking ZS, contrasting with the side effects noted among some PEG recipients. Self-limiting issues like abdominal pain and nausea were reported by children on PEG, prompting concerns about adherence to this conventional treatment. On the other hand, ZS achieved superior medication adherence, as parents reported fewer compliance issues and higher overall tolerance of the syrup.
According to the trial's statistics, 32 patients from the PEG group and 30 from the ZS group completed the study, with no significant differences detected between the two groups concerning age, gender, or baseline weight, pointing to the randomized nature of the sample. Only slight variances were recorded concerning hemoglobin and thyroid-stimulating hormone (TSH) levels, which nevertheless remained clinically insignificant throughout.
The findings align with previous research surrounding Ziziphus jujube, known traditionally for its medicinal properties, including its roles as an analgesic and anti-constipation remedy. Previous studies supporting its laxative effects on adults prompted researchers to explore its application among children—a demographic often overlooked by pharmaceutical innovations. The natural formulation's high fructose content and polyphenolic compounds are believed to play roles in its efficacy, promoting intestinal motility and moisture retention within the stool.
Despite these promising results, researchers caution the need for supplementary studies focusing on long-term effects and broader applications of Ziziphus jujube syrup. They have indicated the primary limitation of their study was the lack of more objective measures for assessing improvement beyond subjective reports from parents.
Given the safety and effectiveness of Ziziphus jujube syrup highlighted through this research, it presents itself as a considerable alternative to traditional laxatives like PEG. This comparative study marks significant progress in the quest for viable treatment options for functional constipation, echoing the necessity to expand knowledge around natural remedy potentials within pediatric care routines.
With approximately 10% of children suffering from functional constipation continuing to have symptoms even after treatment, this research paves the way for integrating Ziziphus jujube syrup within clinical frameworks, contributing to wider acceptance of natural therapies for childhood gastrointestinal disorders.