The use of magnesium-containing mineral waters for functional constipation in children and adolescents

Background. Functional constipation continues to be one of the urgent problems in the practice of a pediatrician and pediatric gastroenterologist. The frequency of constipation in children is about 25−30%. A regular, painless bowel movement with a stool of soft consistency is possible only with a whole range of measures, including the use of laxatives. The possibility of using therapeutic magnesium-containing mineral water as an osmotic laxative in children and adolescents has not been adequately addressed in the literature.

Aim: to study the effectiveness of the use of magnesium-containing mineral water in treatment and prevention of functional constipation in children and adolescents.

Methods. The design was a randomized prospective, open, comparative study. The study included 95 children and adolescents aged 10−16 years (average age 12.7 ± 0.2 years) who were receiving sanatorium therapy with a diagnosis of functional constipation. Follow-up was performed for 18 days. The patients received basic therapy in the form of a sparing-exercise regimen, therapeutic nutrition, health-improving massage, and physiotherapy exercises. The subjects were divided into 2 groups by common randomization. The group 1 consisted of 55 patients who, along with basic treatment, took therapeutic mineral magnesium-containing water. The group 2 (control) consisted of 40 pediatric patients who received only basic treatment. Patient groups were comparable by disease pattern, gender, and age. The examination included a general medical examination, filling out special questionnaires reflecting the frequency and nature of the defecation; assessment of the vegetative status and functional reserves of the body on the Health Sources hardware complex.

Results. In the study group, by the day 5 of therapy, daily defecation was achieved in 49.0% of patients; and by the end of the course of treatment, defecation regularity was registered in 89.1% of children. In the control group, the positive changes were less pronounced and amounted to 55% by the end of the treatment course (p < 0.05). When taking mineral water, the nature of the defecation changed, namely in 89.1% of patients, it became of soft consistency with free painless bowel movement. When assessed according to the Bristol scale, the defecation corresponded to the types 3 and 4 with the initial type 1. In patients who did not receive a course of mineral water, during the entire follow-up period, no significant changes in the nature of defecation were detected, while the type 3 was noted in only 18% of patients by the end of the course of treatment. When taking mineral water, most patients of the main group developed a persistent reflex to morning defecation after ingestion of mineral water.

Conclusion. Studies have shown that magnesium-containing mineral water is an effective, safe and easy to use means of correcting functional constipation in children and can be used both in outpatient practice and in sanatorium treatment.