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Constipation in Children Article
Non-pharmacological treatment for constipation in children:

There is evidence on the use of fibre supplements for the treatment of functional constipation. Systematic reviews report that fibre supplements are more beneficial than placebo. A cow's milk-free diet may be beneficial for children that have an underlying allergy to cow's milk but the evidence is of low-quality. Biofeedback has been shown to have no additional benefit in children with functional constipation. Similarly, behavioural therapy has been shown to have no benefit; although, the evidence is minimal.

An increased intake in fibre and fibre supplements have been shown to improve the symptoms of constipation in comparison to placebo; however, the evidence is limited.

In comparison, other interventions such as: probiotics, dry cupping, and hydration have been shown to have no benefit.

Interventions shown to have no benefit include: probiotics, synbiotics, an increase in water intake, dry cupping, or additional biofeedback or behavioural therapy.

There have been association found between childhood constipation and low consumption of fibre, fruits and vegetables and more frequent consumption of fast foods.

Side effects of polyethylen glycol: flatulence, watery stools, stomach pain, and nausea.

Mechanism of action of fibre

There is soluble and insoluble fibre. Insoluble fibre can interact with water and form a gel-like consistency to improve the consistency of stools and make them easier to pass. Insoluble fibre can increase the size of the stools (bulking), and stimulate the gut mucosa to increase peristalsis.

Cloxacillin
de effects of cloxacillin include diarrhea, vomitting, and nausea.i

Cetirizine

There is a much lower risk of sedation with second-generation H1 receptors compared to first-generation agents like chlorpheniramine. In terms of second-generation anti-histamine, loratadine, fexofenadine and terfenadine are considered non sedating. However, somnolence was noted for cetirizine. Therefore, patients should avoid cetirizine if they plan on doing activities can could put their lives at risk, and should instead choose loratadine, and fexofenadine.

Cetirizine appears to be slightly more effective than other second-generation H1 receptor antagonists for the treatment of urticaria. However, all second-generation anti-histamines are effective for the treatment of urticaria. \

Astemizole, terfenadine, and ebastine should not be chose because of increased risk of cardio toxicity.

Cetirizine in the paediatric population

This study found moderate certainty evidence that CTZ is well established in reducing symptoms and obtaining a better QOL in children with AR from 1 to 12 weeks and has similar efficacy compared with other AHs or montelukast.

The effect of food in cetirizine is not clinically relevant, therefore it can be taken with food.