Background: Chronic constipation is one of the most common chronic disorders of childhood,
affecting 1% to 30% of children worldwide.
Aim: To evaluate the efficacy and feasibility of Pena protocol of bowel management in children
with chronic constipation
Patients and methods: This prospective cross-sectional study was conducted on 63 children with
chronic constipation in the Pediatric Unit of General Surgery Department at Benha University
Hospital
Results: Regarding the final outcome of Pena protocol for management of chronic constipation,
the majority of cases had good response (93.7%) while 4 cases still had no response and needed
surgery. According to the first step of Pena management among studied cases, which is enema,
only 3 cases had antegrade enema and the majority had retrograde enema (95.2%) with mean dose
of enema of 735, ranged from 200 to 1000 ml. For content of enema, one third used saline solution,
also one third used glycerin, then 23.8% used phosphate, while 3 cases only used Castile soap, and
another 3 cases used polyethylene glycol. Regarding the management by laxatives, 34.9% needed
laxatives either due to increased number of enemas or increased dose with the majority used bulk
forming laxative (59.1%), while osmotic and stool softener laxatives were used in 18.25 and
22.7%, respectively, among cases who used laxatives |