Constipation

Loening‐Baucke, Vera; Swidsinski, Alexander

doi:10.1007/978-1-60761-709-9_39

Cited by 4 publications

(4 citation statements)

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“…We are not certain why adding anal sphincter biofeedback did not result in additional improvement. The biofeedback protocol was designed around the observation that many children with encopresis exhibit paradoxic constriction of the anal sphincter during attempted defecation (8,(12)(13)(14)(15)(16). We have recently shown that findings identified with anorectal manometry do not predict response to treatment (36).…”

Section: Discussionmentioning

confidence: 99%

“…Because more than half of children with chronic encopresis demonstrate paradoxic constriction of the external anal sphincter during attempted defecation, more recent literature advocates the use of external anal sphincter biofeedback to treat chronic encopresis (8,(12)(13)(14)(15)(16). Biofeedback focuses on teaching the child to reverse paradoxic constriction by learning how to relax the external anal sphincter during straining.…”

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confidence: 99%

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Treatment of Childhood Encopresis: A Randomized Trial Comparing Three Treatment Protocols

Borowitz,

Cox,

Sutphen

et al. 2002

J. pediatr. gastroenterol. nutr.

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ObjectivesTo compare short‐ and long‐term effectiveness of three additive treatment protocols in children experiencing chronic encopresis.MethodsChildren, 6 to 15 years of age, who experienced at least weekly fecal soiling for 6 months or longer were eligible for the study. Children were randomly assigned to a group that received intensive medical therapy (IMT), a group that received intensive medical therapy plus a behavior management program called enhanced toilet training (ETT), or a group that received intensive medical therapy with enhanced toilet training and external anal sphincter electromyographic biofeedback (BF). Data concerning toileting habits were collected for 14 consecutive days before an initial visit, and at 3, 6, and 12 months after initiation of therapy. All data were collected using a computerized voice‐mail system that telephoned the families each day. At 12 months, children were classified as significantly improved (reduction in soiling, P < 0.001) or cured (<one fecal accident in 2 weeks).ResultsEighty‐seven children participated in the study, 72 boys and 15 girls. Mean age at enrollment was 8.6 ± 2.0 years, and mean duration of symptoms was 58.2 ± 38.5 months. At 12 months, the cure rates for the IMM, ETT, and BF groups were 36, 48, and 39, respectively (not significant). The improvement rates for these three groups were 45, 78, and 54, respectively (P < 0.05). These results were very stable over time (r > 0.90, P < 0.001 in each case). Response to treatment during the first 2 weeks of therapy was highly predictive of outcome at 3, 6, and 12 months (P < 0.0001). Children in the ETT group used less laxative medication (P < 0.04) and required fewer treatment contacts (P = 0.08) than children in the IMM group. All three treatments resulted in significant increases in daily bowel movements passed in the toilet and self‐initiated toileting, and resulted in decreases in average daily soiling at 3, 6, and 12 months (P < 0.05).ConclusionsEnhanced toilet training is somewhat more effective in treating childhood encopresis than either intensive medical therapy or anal sphincter biofeedback therapy. Although similar total cure rates at 1 year can be expected with these three forms of therapy, enhanced toilet training results in statistically significant decreases in the daily frequency of soiling for the greatest number of children.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Treatment of Childhood Encopresis: A Randomized Trial Comparing Three Treatment Protocols

Borowitz,

Cox,

Sutphen

et al. 2002

J. pediatr. gastroenterol. nutr.

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“…Chronic constipation is one of the most common causes of morbidity in childhood (1‐3). Numerous hypotheses for its pathogenesis have been proposed.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic constipation is one of the most common disorders in Western countries. Field surveys have shown that up to 10% of children suffer from chronic constipation (1‐3), but only 3% of parents seek medical advice (4).…”

mentioning

confidence: 99%

Diet and Chronic Constipation in Children: The Role of Fiber

Roma,

Adamidis,

Nikolara

et al. 1999

J. pediatr. gastroenterol. nutr.

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Background:Chronic constipation is one of the most common disorders in Western countries and despite numerous clinical, pathophysiologic, and epidemiologic studies its cause is still unclear. Several hypotheses have been proposed and according to experimental studies and clinical observation, fiber intake could play a role in its pathogenesis. The purpose of this case‐control study was to examine the possible correlation of idiopathic chronic constipation in children and dietary intake, particularly fiber intake.Methods:A randomized sample of children (291 children with constipation and 1602 controls) aged 2 to 14 years was taken from three of the 52 counties of Greece. Stratification was performed on the basis of urban, rural, or suburban location and socioeconomic status. The nutritional data were obtained from a 3‐day dietary record and a dietary history. Statistical analysis was performed with multivariate tests, multivariate analysis of variance, discriminant analysis, and chi‐square analysis according to the characteristics of the correlated variables.Results:Constipated children had a lower caloric and nutrient intake (p < 0.001), lower body weight/height (p < 0.001), and higher prevalence of reported anorexia (p < 0.001). Discriminant analysis indicated that dietary fiber alone was independently negatively correlated with chronic constipation, despite the age and the age of onset of constipation. Relative risk also had a negative correlation with fiber intake (p < 0.001). Of the main fiber fractions only cellulose and pentose were independently correlated with chronic constipation.Conclusions:Lack of fiber may play an important role in the etiology of chronic idiopathic constipation in children.

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Treatment of functional constipation and fecal incontinence

Loening‐Baucke

Swidsinski

2015

Pediatric Incontinence

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Constipation

Cited by 4 publications

References 74 publications

Treatment of Childhood Encopresis: A Randomized Trial Comparing Three Treatment Protocols

Treatment of Childhood Encopresis: A Randomized Trial Comparing Three Treatment Protocols

Diet and Chronic Constipation in Children: The Role of Fiber

Treatment of functional constipation and fecal incontinence

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