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On average, infants have 3-4 bowel movements/day, and toddlers have 2-3 bowel movements per day. At around age 4, children develop an adult-like pattern of bowel movements (1-2 stools/day). The median onset of functional constipation in children is at 2.3 years old, with girls and boys being similarly affected. [2]
Nicotinamide may be toxic to the liver at doses exceeding 3 g/day for adults. [74] Prescription products can be immediate release (Niacor, 500 mg tablets) or extended release (Niaspan, 500 and 1000 mg tablets). Niaspan has a film coating that delays release of the niacin, resulting in an absorption over a period of 8–12 hours.
Independently of clinical symptoms, blood level of tryptophan or urinary metabolites such as 2-pyridone/N-methylnicotinamide ratio <2 or NAD/NADP ratio in red blood cells can diagnose pellagra. The diagnosis is confirmed by rapid improvements in symptoms after doses of nicotinamide (250–500 mg/day) or nicotinamide enriched food. [7]
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. [2] The stool is often hard and dry. [4] Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. [3]
Nicotinamide (INN, BAN UK [2]) or niacinamide (USAN US) is a form of vitamin B 3 found in food and used as a dietary supplement and medication. [ 3 ] [ 4 ] [ 5 ] As a supplement, it is used orally (swallowed by mouth) to prevent and treat pellagra (niacin deficiency). [ 4 ]
The symptoms are similar to pellagra, including red, scaly rash and sensitivity to sunlight. Oral nicotinic acid or nicotinamide is given as a treatment for this condition in doses ranging from 50 to 100 mg twice a day, with a good prognosis if identified and treated early. [28]
Mineral oils, such as liquid paraffin, are generally the only nonprescription lubricant laxative available, but due to the risk of lipid pneumonia resulting from accidental aspiration, mineral oil is not recommended, especially in children and infants. [10] [11] Mineral oil may decrease the absorption of fat-soluble vitamins and some minerals. [9]
A normal intake of fiber is advocated for children with functional constipation, as per the criteria of ESPGHAN/NASPGHAN. It is not recommended to increase the consumption of fiber above what is considered normal. [14] In order to effectively treat childhood constipation, it is imperative that parents and children receive counseling.
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