{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:58:41Z","timestamp":1790913521349,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":341,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To characterize real\u2010world pharmacotherapy patterns among Japanese children with chronic functional constipation (CFC), with particular attention to changes after the market introduction of polyethylene glycol (PEG) 4000 in 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This longitudinal descriptive study was conducted using a Japanese health insurance claims database. We identified children aged 0\u201314\u2009years who had an outpatient claim with a constipation diagnosis and received an initial prescription for laxatives lasting \u22655\u2009days at the same visit between 2012 and 2022. We described baseline characteristics and laxative treatment trajectories throughout a 12\u2010month follow\u2010up. Subgroup analyses were performed by sex, age, and institution type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 166,808 eligible children, 64.1% entered the cohort after 2019. Mean age was 4.0\u2009years and 56.6% were female. Magnesium oxide was the most commonly used laxative (31.0%), followed by PEG 4000 (19.9%). Introduction of PEG 4000 in 2019 was accompanied by a decline in prescriptions for other conventional agents. Medication choices varied by age: magnesium oxide was predominant across all age groups; PEG 4000, malt extract, and lactulose were more commonly used in younger children; and traditional Japanese Kampo medicine was favored in older children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Magnesium oxide remains the most frequently prescribed laxative for pediatric CFC in Japan, with PEG 4000 now ranking second. The introduction of PEG 4000 in 2019 reduced reliance on other conventional laxatives. These findings may help clinicians tailor pharmacotherapy for childhood constipation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70293","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T09:58:27Z","timestamp":1765187907000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of laxative use for chronic functional constipation in Japanese children: A longitudinal descriptive study"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8460-1456","authenticated-orcid":false,"given":"Takenori","family":"Akaike","sequence":"first","affiliation":[{"name":"Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health Kyoto University  Kyoto Japan"},{"name":"Japan Oncology Clinical Sciences Development, Oncology Therapeutic Area Unit Takeda Pharmaceutical Company Limited  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7147-0737","authenticated-orcid":false,"given":"Toshiki","family":"Fukasawa","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8558-4950","authenticated-orcid":false,"given":"Takanori","family":"Yanai","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7309-5627","authenticated-orcid":false,"given":"Munenori","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health Kyoto University  Kyoto 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