Pharmacotherapy for pediatric chronic intestinal pseudo-obstruction: Nationwide survey in Japan

Pediatr Int. 2017 Apr;59(4):467-472. doi: 10.1111/ped.13201. Epub 2017 Feb 2.

Abstract

Background: Chronic intestinal pseudo-obstruction (CIPO) is a rare disabling and life-threatening disorder characterized by severe impairment of gastrointestinal peristalsis. While a number of pharmacotherapeutics have been developed, only a few trials have been carried out for improvement of the pathological condition of CIPO patients. This report describes the results of a nationwide survey on the pharmacotherapy used in pediatric CIPO in Japan.

Methods: In 2012, a nationwide survey was conducted to identify the clinical presentation of CIPO in Japan. Information was gathered on pharmacotherapy. Four categories were created for medicines used in pharmacotherapy: "probiotics", "Japanese herbal medicines (Kampo medicines)", "laxatives", and "prokinetics".

Results: Ninety-two responses were collected from 47 facilities. Of the 62 patients who met the diagnostic criteria, 52 were treated with medications, while the remaining 10 were not. Thirty-four patients were given a total of 49 probiotics; 39 were treated with a total of 50 Kampo medicines; 20 were treated with a total of 28 laxatives; and 26 were given a total of 30 prokinetics, 70% of whom were treated specifically with mosapride.

Conclusion: Traditional Japanese medicines such as Kampo medicines and mosapride are often used to treat CIPO in Japan. Two combinations, that is, probiotics and Kampo medicines; and Kampo medicines and prokinetics, were often used for pediatric CIPO in Japan.

Keywords: child; chronic intestinal pseudo-obstruction; nationwide survey; pharmacotherapy.

MeSH terms

  • Adolescent
  • Adult
  • Benzamides / therapeutic use
  • Child
  • Child, Preschool
  • Chronic Disease
  • Drug Therapy, Combination
  • Drug Utilization / statistics & numerical data*
  • Female
  • Gastrointestinal Agents / therapeutic use*
  • Health Care Surveys
  • Humans
  • Infant
  • Infant, Newborn
  • Intestinal Pseudo-Obstruction / drug therapy*
  • Japan
  • Laxatives / therapeutic use
  • Male
  • Medicine, Kampo / statistics & numerical data*
  • Morpholines / therapeutic use
  • Phytotherapy / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Probiotics / therapeutic use*
  • Young Adult

Substances

  • Benzamides
  • Gastrointestinal Agents
  • Laxatives
  • Morpholines
  • mosapride