[Modern possibilities of cryotherapy for chronic functional constipation in children].

Introduction: Among the urgent problems of pediatrics, chronic constipation occupies one of the leading positions due to its high prevalence (20-40%) and the possibility of complications. Conductive cryotherapy, used separately and in combination with percutaneous electroneurostimulation, is a promising technology for the treatment of chronic constipation in children.
Aim of Study: Scientific evidence of the use of conductive cryotherapy and its combined effect with percutaneous electroneurostimulation in children with chronic constipation.
Materials and Methods: We examined 80 children aged 3-15 years (average age 8±2 years) suffering from chronic constipation: 35 (43.8%) boys, 45 (56.2%) girls. In 47 (58.8%) children, chronic constipation of the hypotonic type (HT) was detected, in 33 (41.2%) - chronic constipation of the spastic type (ST). Children were divided into 4 groups, comparable in number, age, gender and clinical manifestations. Patients of all groups received basic treatment: laxative diet, probiotics, choleretic drugs, enzymes. Patients of the main group used the combined effect of conduction cryotherapy and percutaneous electroneurostimulation - cryoelectroneurostimulation. Conduction cryotherapy was prescribed for children of the 1st comparison group, percutaneous electroneurostimulation was assigned to the 2nd comparison group. Patients in the control group received only basic therapy. In order to assess the effectiveness of impact of physical factors, clinical and functional examinations of children were carried out before treatment, immediately after the course of treatment, and also 3, 6 and 12 months later after treatment.
Results and Discussion: The highest treatment efficacy was found in children of the main group with HT and ST (91.6 and 87.5%, respectively) after cryoelectronic neurostimulation. Conduction cryotherapy was most effective for the treatment of ST (77.7%). The results of the study made it possible to develop an algorithm for the prescription of percutaneous electroneurostimulation and conduction cryotherapy, depending on the type of dyskinetic disorders of the colon in children. All children, regardless of the type of chronic constipation, are prescribed to use the combined effects of physical factors (cryoelectroneurostimulation), percutaneous electroneurostimulation is recommended for HT, conductive cryotherapy - for ST.
Conclusion: The higher therapeutic effectiveness of the combined use of conduction cryotherapy and percutaneous electroneurostimulation in various types of dyskinetic disorders in children has been proved according to immediate and long-term results of treatment. An algorithm is proposed for differential use of conduction cryotherapy and percutaneous electroneurostimulation taking into account the type of dyskinetic disorders of the colon.