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Cited by 110Gastrointestinal motility and disordersPelvic floor disorders treatmentsFood composition and properties

A controlled, randomized, double-blind trial to evaluate the effect of a supplement of cocoa husk that is rich in dietary fiber on colonic transit in constipated pediatric patients

Castillejo, Gemma, Bulló, Mònica, Anguera, Anna, Escribano, Joaquin, Salas-Salvadó, Jordi·2006·PEDIATRICS
DOI 10.1542/peds.2006-0090
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Abstract

OBJECTIVE: Although a diet that is rich in fiber is widely recommended for preventing and treating constipation, the efficacy of fiber supplements have not been tested sufficiently in children. Our aim with this pilot study was to evaluate if fiber supplementation is beneficial for the treatment of children with idiopathic chronic constipation. METHODS: Using a parallel, randomized, double-blind, controlled trial, we conducted an interventional study to evaluate the efficacy of a supplement of cocoa husk rich in dietary fiber on intestinal transit time and other indices of constipation in children with constipation. After screening, the patients were randomly allocated to receive, for a period of 4 weeks, either a cocoa husk supplement or placebo plus standardized toilet training procedures. Before and after 4 weeks of treatment, we (1) performed anthropometry, a physical examination, and routine laboratory measurements, (2) determined total and segmental colonic transit time, (3) evaluated bowel movement habits and stool consistency using a diary, and (4) received a subjective evaluation from the parents regarding the efficacy of the treatment. The main variable for verifying the efficacy of the treatment was the total colonic transit time. RESULTS: Fifty-six chronically constipated children were randomly assigned into the study, but only 48 children completed it. These children, who were aged between 3 and 10 years, had a diagnosis of chronic idiopathic constipation. With respect to total, partial colon, and rectum transit time, there seemed to be a trend, although statistically nonsignificant, toward faster transit times in the cocoa husk group than in the placebo group. When we analyzed the evolution of the intestinal transit time throughout the study of children whose total basal intestinal transit time was > 50th percentile, significant differences were observed between the groups. The total transit time decreased by 45.4 +/- 38.4 hours in the cocoa husk group and by 8.7 +/- 28.9 hours in the placebo group (-38.1 hours). In the case of the right colon, changes in transit time also were significant between groups. Mean changes tended toward faster transit times in the left colon and the rectum, although the differences were not statistically significant. The children who received cocoa husk supplements tended to increase the number of bowel movements by more than that of the children of the placebo group. We also observed a reduction in the percentage of patients who reported hard stools (hard scybalous or pebble-like stools), although this reduction was significantly greater in the cocoa husk group. At the end of the intervention, 41.7% and 75.0% of the patients who received cocoa husk supplementation or placebo, respectively, reported having hard stools. Moreover, a significantly higher number of children (or their parents) reported a subjective improvement in stool consistency. No significant adverse effects were reported during the study. CONCLUSIONS: This study confirms the beneficial effect of a supplement of cocoa husk that is rich in dietary fiber on chronic idiopathic constipation in children. These benefits seem to be more evident in pediatric constipated patients with slow colonic transit time.

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  • Interventions with probiotics, prebiotics, and fecal-microbiota transplantation improved colonic transit and defecation frequency.

    “interventions with probiotics, prebiotics, and fecal-microbiota transplantation improved colonic transit and defecation frequency [ 21–23 ]”

    From Role of gut microbiota in functional constipation (2021) · cites this paper as [22]

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Authors
Castillejo, G., Bulló, M., Anguera, A., Escribano, J., & Salas-Salvadó, J.
Affiliations
  • Unité de Nutrition Humaine (FR)
  • Human Nutrition Unit
  • Research Department, Madaus, SA, Barcelona, Spain
  • Pediatrics Department, Hospital Universitari de Sant Joan de Reus, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain
ORCID
Castillejo, Gemma
Venue
PEDIATRICS
Publisher
American Academy of Pediatrics (AAP)
Published
2006-09-01
Volume
118
Issue
3
Pages
e641-e648
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2006-0090
OpenAlex
W2115012443
Cited by
110
References
39
Citations by year
2026: 1 · 2025: 3 · 2024: 6 · 2023: 6 · 2022: 7 · 2021: 6 · 2020: 5 · 2019: 8 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 6 · 2014: 5 · 2013: 6 · 2012: 10
FWCI
4.29
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
  • Repositori institucional URV (Universitat Rovira i Virgili) (submittedVersion)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
Keywords
cocoa pod husk, dietary fiber supplementation, chronic idiopathic constipation, pediatric constipation, colonic transit time, stool frequency, stool consistency, functional gastrointestinal disorders, toilet training, laxatives, quality of life, school absenteeism, psychosocial functioning
MeSH terms
Cacao, Child, Child, Preschool, Colon, Constipation, Dietary Fiber, Double-Blind Method, Female, Gastrointestinal Transit, Humans, Male, Treatment Outcome, Plant Structures

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